Utility of medical and drug history in fracture risk prediction among men and women

Staa, Tjeerd van; Leufkens, Hubert G. M.; Cooper, Cyrus

doi:10.1016/s8756-3282(02)00848-7

Cited by 85 publications

(38 citation statements)

References 20 publications

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“…Furthermore, both the main exposure and the outcome of interest have been studied using data from the GPRD, and these have been found to be accurately registered in the data set (16,38). Moreover, large samples of data from the GPRD, similar to the data set used herein, have previously been successfully used to assess fracture risk (39) and to study the epidemiology of fractures in England and Wales (1). The longitudinal nature of this data set allows the temporal trends in the association between hip OA and fracture to be explored accurately.…”

Section: Discussionmentioning

confidence: 99%

Fracture risk before and after total hip replacement in patients with osteoarthritis: Potential benefits of bisphosphonate use

Prieto-Alhambra¹,

Javaid²,

Judge³

et al. 2011

Arthritis & Rheumatism

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Objective. The association between osteoarthritis (OA) and fractures remains unclear. OA patients have increased bone mass, but no corresponding decrease in fracture rate. This study was undertaken to determine the fracture rates in patients with hip OA undergoing a total hip replacement (THR), as compared with diseasefree controls, and to assess the association between bisphosphonate use and postsurgery fracture risk.Methods. We conducted a population-based parallel-cohorts study. All patients in the UK General Practice Research Database undergoing a THR for hip OA between 1986 and 2006 constituted the exposed cohort (n ‫؍‬ 14,133). Five disease-free controls were matched with each patient by age, sex, and practice site. Subjects were followed up for 5 years before and after surgery. Fracture rates and rate ratios (RRs) were estimated using Poisson regression. In addition, bisphosphonate use was identified among patients undergoing THR, and the data, stratified by the presence or absence of a previous fracture and by treatment propensity score, were assessed using fitted Cox models to study the effect of bisphosphonate use on the risk of fracture postsurgery.Results. Patients undergoing a THR had a similar fracture risk as that in controls in the 5 years before THR, but had higher rates postsurgery, which peaked at years 2. Conclusion. This study identified a 25% increase in fracture risk at 2.5-5 years postsurgery among patients undergoing a THR. Bisphosphonate use reduced the post-THR risk of fracture when administered both as primary prevention and as secondary prevention, by 44% and 52%, respectively. This must be further confirmed in randomized controlled trials.

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Section: Discussionmentioning

confidence: 99%

Fracture risk before and after total hip replacement in patients with osteoarthritis: Potential benefits of bisphosphonate use

Prieto-Alhambra¹,

Javaid²,

Judge³

et al. 2011

Arthritis & Rheumatism

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“…Potential confounders in this study were clinical variables based on diagnosis and/or medication use that have previously been associated with risk of fractures [35]. The diagnosis of neurologic/psychiatric condition in the year before the index date included cerebrovascular disease, dementia, depression, psychotic disorder and seizures.…”

Section: Assessment Of Potential Confoundersmentioning

confidence: 99%

Risk of hip/femur fractures in patients using antipsychotics

Hugenholtz

Heerdink

Staa

et al. 2005

Bone

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The objective of our study was to investigate whether use of antipsychotics is associated with hip/femur fractures and whether pharmacological differences between antipsychotics are related to the occurrence of fractures.A case-control study was conducted, in which cases were defined as patients with a hip/femur fracture. Each patient was matched to one control patient. The association between use of antipsychotics and the occurrence of hip/femur fractures was evaluated using conditional logistic regression.The study included 44,500 patients from 683 general practices from different geographical areas in the UK, registered within the General Practice Research Database (GPRD). Exposure to antipsychotics was categorized as "no use", "current use" and "prior use".Both current and prior use of antipsychotics were associated with an approximately two-fold increased risk of fractures. After adjustment for possible confounders, a small significant effect remained (Odds Ratios (OR) of 1.3). We did not find an association between dose of antipsychotics, or between the degree of blockade of the alpha-1 adrenoceptor or histamine-1 receptor and risk of fractures. The total number of days of antipsychotic use was significantly associated with an increased risk of hip/femur fractures.We conclude that there is a small increased risk of hip/femur fractures associated with the use of antipsychotics. This risk increases with long-term use.

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“…Long-term treatment with AEDs is associated with a facilitated rate of bone loss, and consequently an increased risk of bone fractures (10,19,41). Although topiramate and lamotrigine were approved for clinical use, there are limited data regarding their effects on bone metabolism.…”

Section: Discussionmentioning

confidence: 99%

“…Long-term treatment with antiepileptic drugs (AEDs) has been correlated with bone loss and consequently increased risk of bone fractures (10,19,41). Bone is maintained by continuous remodeling, involving bone formation and bone resorption (31).…”

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confidence: 99%

<b>Effects of the antiepileptic drugs topiramate and lamotrigine on bone metabolism in </b><b>rats </b>

et al. 2017

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Long-term treatment with antiepileptic drugs (AED) is associated with an elevated risk of bone fracture due to decreased bone mineral density (BMD). Phenytoin has been shown to affect bone metabolism adversely, whereas newly developed AEDs have not been studied. This study evaluated the effects of topiramate and lamotrigine on bone metabolism in rats. Five-week-old male Sprague-Dawley rats were treated orally with phenytoin (20 mg/kg), topiramate (5 or 20 mg/kg), or lamotrigine (2 or 10 mg/kg) daily for 12 weeks. Phenytoin reduced bone strength, measured by maximum load to failure of the femoral mid-diaphysis, along with reduced femur total BMD. Serum tartrate-resistant acid phosphatase-5b levels significantly increased after phenytoin treatment, while serum osteocalcin levels decreased after topiramate 20 mg/kg treatment. Furthermore, osteoblast surface and bone mineralizing surface were significantly lowered by topiramate. Lamotrigine treatment did not affect bone strength, BMD, or bone turnover. We demonstrated that phenytoin treatment significantly increased bone resorption and lowered BMD and bone strength. Since lamotrigine did not affect bone metabolism, it can be concluded that lamotrigine is safety medicine for bone health. Topiramate was associated with decreased bone formation, which may affect bone strength and BMD with chronic use. Thus, patients taking topiramate should be monitored for changes in BMD to avoid risk of fracture.

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Utility of medical and drug history in fracture risk prediction among men and women

Cited by 85 publications

References 20 publications

Fracture risk before and after total hip replacement in patients with osteoarthritis: Potential benefits of bisphosphonate use

Fracture risk before and after total hip replacement in patients with osteoarthritis: Potential benefits of bisphosphonate use

Risk of hip/femur fractures in patients using antipsychotics

<b>Effects of the antiepileptic drugs topiramate and lamotrigine on bone metabolism in </b><b>rats </b>

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