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Influence of non-osteoporotic treatments in patients on active anti-osteoporotic therapy: evidence from the OSTEOMED registry

Abstract: Purpose To evaluate the effect of different non-osteoporotic drugs on the increase or decrease in the risk of incident fragility fractures (vertebral, humerus or hip) in a cohort of patients diagnosed with osteoporosis on active anti-osteoporotic therapy. Methods For this retrospective longitudinal study, baseline and follow-up data on prescribed non-osteoporotic treatments and the occurrence of vertebral, humerus or hip fractures in 993 patients from the OSTEOMED registry were analyzed using logistic regression models. The drugs evaluated with a possible beneficial effect were thiazides and statins, while the drugs evaluated with a possible harmful effect were antiandrogens, aromatase inhibitors, proton pump inhibitors, selective serotonin reuptake inhibitors, benzodiazepines, GnRH agonists, thyroid hormones, and oral and inhaled corticosteroids. Results Logistic regression analyses indicated that no treatment significantly improved fracture risk, with the only treatments that significantly worsened fracture risk being letrozole (OR = 0.18, p-value = 0.03) and oral corticosteroids at doses <_5 mg/day (OR = 0.16, p-value = 0.03) and >5 mg/day (OR = 0.27, p-value = 0.04). Conclusion The potential beneficial or detrimental effects of the different drugs evaluated on fracture risk are masked by treatment with anabolic or antiresorptive drugs that have a more potent action on bone metabolism, with two exceptions: letrozole and oral corticosteroids. These findings may have important clinical implications, as patients receiving these treatments are not fully protected by bisphosphonates, which may imply the need for more potent anti-osteoporotic drugs such as denosumab or teriparatide

 Fuente: European Journal of Clinical Pharmacology, 2023, 79, 1333-1339

 Editorial: Springer

 Año de publicación: 2023

 Nº de páginas: 7

 Tipo de publicación: Artículo de Revista

 DOI: 10.1007/s00228-023-03544-x

 ISSN: 0031-6970,1432-1041

 Url de la publicación: https://doi.org/10.1007/s00228-023-03544-x

Autoría

COCO-MARTÍN, MARÍA

LEAL-VEGA, LUIS

BLÁZQUEZ-CABRERA, JOSÉ ANTONIO

NAVARRO, AMALIA

MORO, MARÍA JESÚS

ARRANZ-GARCÍA, FRANCISCA

AMÉRIGO, MARÍA JOSÉ

SOSA-HENRÍQUEZ, MANUEL

VÁZQUEZ, MARÍA ÁNGELES

MONTOYA, MARÍA JOSÉ

DÍAZ-CURIEL, MANUEL

RUIZ-MAMBRILLA, MARTA

FILGUEIRA-RUBIO, JOSÉ

PÉREZ-CASTRILLÓN, JOSÉ LUIS

OSTEOMED GROUP