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Risk of osteoporosis in patients with atrial fibrillation with and without oral anticoagulant therapy


Bezabhe, WM and Radford, J and Wimmer, BC and Salahudeen, MS and Bindoff, I and Ling, T and Peterson, GM, Risk of osteoporosis in patients with atrial fibrillation with and without oral anticoagulant therapy, Expert Review of Clinical Pharmacology, 15, (8) pp. 1003-1010. ISSN 1751-2433 (2022) [Refereed Article]

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DOI: doi:10.1080/17512433.2022.2103540


Background: We aimed to compare the risk of developing osteoporosis in patients prescribed warfarin or direct-acting oral anticoagulants (DOACs) with those with no therapy.

Research design and methods: We included 37,632 patients aged between 18 and 111 years with a recorded diagnosis of AF between 1 January 2013 and 31 December 2017. Patients were followed until the diagnosis of osteoporosis, switch or discontinuation of the OAC, last clinical visit, or end of the study period, whichever occurred first. The incidences of new-onset osteoporosis were calculated using the Cox proportional hazards model.

Results: Of total, 16,995 (45.2%) had no recorded OAC prescription, and 20,637 had a recorded prescription of warfarin (6,609) or DOAC (14,028). Compared with those not prescribed an OAC, the risk of being diagnosed with new-onset osteoporosis increased in patients prescribed warfarin (HR 2.22, 95% CI 2.00-2.47, p < 0.001) and DOACs (HR 1.42, 95% CI 1.29-1.58, p < 0.001). However, the effect of DOACs was not statistically significant (HR 1.07, 95% CI 0.86-1.33, p < 0.535) after excluding patients with at least one recorded prescription of systemic corticosteroids, antiepileptics, or proton pump inhibitors.

Conclusions: Use of warfarin or DOACs was associated with a significantly increased risk of developing osteoporosis compared with no OAC treatment.

Item Details

Item Type:Refereed Article
Keywords:oral anticoagulant, atrial fibrillation, osteoporosis, warfarin, direct acting oral anticoagulant
Research Division:Biomedical and Clinical Sciences
Research Group:Pharmacology and pharmaceutical sciences
Research Field:Clinical pharmacy and pharmacy practice
Objective Division:Health
Objective Group:Evaluation of health and support services
Objective Field:Evaluation of health outcomes
UTAS Author:Bezabhe, WM (Dr Woldesellassie Bezabhe)
UTAS Author:Radford, J (Professor Jan Radford)
UTAS Author:Wimmer, BC (Dr Barbara Wimmer)
UTAS Author:Salahudeen, MS (Dr Mohammed Salahudeen)
UTAS Author:Bindoff, I (Dr Ivan Bindoff)
UTAS Author:Ling, T (Dr Tristan Ling)
UTAS Author:Peterson, GM (Professor Gregory Peterson)
ID Code:151102
Year Published:2022
Deposited By:Pharmacy
Deposited On:2022-07-18
Last Modified:2022-09-20

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