Risk of venous thromboembolism among users of different anti-osteoporosis drugs:a population-based cohort analysis including over 200,000 participants from Spain and the UK

Autor: Daniel Prieto-Alhambra, Irene Petersen, Antonella Delmestri, Cyrus Cooper, T P van Staa, Samuel Hawley, Muhammad Javaid, Elisa Martín-Merino, S Khalid, Ana Llorente-García, Arturo Álvarez-Gutiérrez, Andrew Judge
Přispěvatelé: Afd Pharmacoepi & Clinical Pharmacology, Pharmacoepidemiology and Clinical Pharmacology
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Male
Endocrinology
Diabetes and Metabolism
Thiophenes/adverse effects
Cohort Studies
0302 clinical medicine
Strontium ranelate
Teriparatide
80 and over
Electronic health records
030212 general & internal medicine
Bone Density Conservation Agents/adverse effects
Denosumab/adverse effects
Aged
80 and over
Alendronate
Bone Density Conservation Agents
Diphosphonates
United Kingdom/epidemiology
Hazard ratio
Alendronate/adverse effects
Venous Thromboembolism
Pharmacoepidemiology
Middle Aged
Primary care
Diphosphonates/adverse effects
Denosumab
Cohort
Spain/epidemiology
Female
medicine.drug
Cohort study
Venous thromboembolism
medicine.medical_specialty
030209 endocrinology & metabolism
Thiophenes
Risk Assessment
Bazedoxifene
03 medical and health sciences
Primary Health Care/methods
Teriparatide/adverse effects
Internal medicine
medicine
Humans
Anti-osteoporosis medication
Risk Assessment/methods
Aged
Primary Health Care
business.industry
United Kingdom
Spain
Venous Thromboembolism/chemically induced
business
Zdroj: Martín-Merino, E, Petersen, I, Hawley, S, Álvarez-Gutierrez, A, Khalid, S, Llorente-Garcia, A, Delmestri, A, Javaid, M K, Van Staa, T P, Judge, A, Cooper, C & Prieto-Alhambra, D 2018, ' Risk of venous thromboembolism among users of different anti-osteoporosis drugs : a population-based cohort analysis including over 200,000 participants from Spain and the UK ', Osteoporosis International, vol. 29, no. 2, pp. 467–478 . https://doi.org/10.1007/s00198-017-4308-5
Osteoporosis International, 29(2), 467. Springer London
ISSN: 0937-941X
DOI: 10.1007/s00198-017-4308-5
Popis: Summary: The venous thromboembolism risk among anti-osteoporotics is unknown. In this primary care study, the risk with other bisphosphonates [1.05 (0.94–1.18) and 0.96 (0.78–1.18)], strontium [0.90 (0.61–1.34) and 1.19 (0.82–1.74)], in the UK and Spain respectively, and denosumab [1.77 (0.25–12.66)] and teriparatide [1.27 (0.59–2.71)] in Spain, did not differ versus alendronate. Introduction: Most of the known adverse drug reactions described for anti-osteoporosis medication (AOM) have been described in studies comparing AOM users to non-users. We aimed to compare the risk of venous thromboembolism (VTE) among incident users of different AOM compared to alendronate (first line therapy). Methods: Two cohort studies were performed using data from the UK (CPRD) and Spain (BIFAP) primary care records separately. All patients aged ≥ 50 years with at least 1 year of data available and a new prescription or dispensation of AOM (date for therapy initiation) during 2000–2014 (CPRD) or 2001–2013 (BIFAP) were included. Users of raloxifene/bazedoxifene were excluded from both databases. Five exposure cohorts were identified according to first treatment: (1) alendronate, (2) other bisphosphonates, (3) strontium ranelate, (4) denosumab, and (5) teriparatide. Participants were followed from the day after therapy initiation to the earliest of a treated VTE (cases), end of AOM treatment (defined by a refill gap of 180 days), switching to an alternative AOM, drop-out, death, or end of study period. Incidence rates of VTE were estimated by cohort. Adjusted hazard ratios (HR 95%CI) were estimated according to drug used. Results: Overall, 2035/159,209 (1.28%) in CPRD and 401/83,334 (0.48%) in BIFAP had VTE. Compared to alendronate, adjusted HR of VTE were 1.05 (0.94–1.18) and 0.96 (0.78–1.18) for other bisphosphonates, and 0.90 (0.61–1.34) and 1.19 (0.82–1.74) for strontium in CPRD and BIFAP, respectively; 1.77 (0.25–12.66) for denosumab and 1.27 (0.59–2.71) for teriparatide in BIFAP. Conclusions: VTE risk during AO therapy did not differ by AOM drug use. Our data does not support an increased risk of VTE associated with strontium ranelate use in the community.
Databáze: OpenAIRE
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