Atrial fibrillation and the use of oral bisphosphonates
Atrial fibrillation and the use of oral bisphosphonates
Background: Epidemiological studies investigating a possible association between bisphosphonates and atrial fibrillation (AF) have reported conflicting findings. The objective of our study was to determine whether exposure to oral nitrogen-containing bisphosphonates alendronate and risedronate are associated with increased incidence of atrial fibrillation.
Methods: In a retrospective cohort study we analyzed data from three large independent databases, two from the United States (MarketScan® and Ingenix®) and one from the United Kingdom (THIN). 144,548 women, age 50–89, bisphosphonate users during 2002–2005 were compared to 668,891 sex- and age-matched controls (1:4). Our primary outcome measure was new incident atrial fibrillation for up to three years; Cox models adjusted for disease and drug history were used to estimated relative risks.
Results: We identified a total of 8,001, 1,984, and 817 AF cases in oral bisphosphonate users and nonusers during 744,340 (MarketScan), 243,898 (Ingenix), and 148,779 (THIN) person-years of follow-up, respectively. Compared to nonusers, overall adjusted relative risk (adjRR) (95% confidence interval [CI]) for AF in oral bisphosphonates users was 0.92 (0.85–0.99; MarketScan), 1.00 (0.87–1.16; Ingenix), and 0.97 (0.79–1.20; THIN); overall adjRR (95% CI) for any cardiac dysrrhythmia for MarketScan was 1.01 (0.98–1.05), Ingenix 1.06 (0.99–1.13), and THIN 0.97 (0.79–1.20).
Conclusions: In all three databases from the two countries, the risk of AF or cardiac dysrrhythmia was not increased in postmenopausal women treated for up to three years with oral alendronate or risedronate.
atrial fibrillation, chemically induced osteoporosis, drug therapy, alendronate or risedronate, bisphosphonates, adverse effects
131-144
Pazianas, Michael
dcba1270-21c4-4b16-b0ca-4ec9ad12eecc
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Wang, Yiting
9d1db41f-7eab-4e56-91f0-a95bb8c16ab0
Lange, Jeff L.
6814e919-75c2-4bfc-9a97-1ee3640e164b
Russell, R. Graham
aff1faf0-6fa7-4a26-beba-f72e9d03982c
March 2011
Pazianas, Michael
dcba1270-21c4-4b16-b0ca-4ec9ad12eecc
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Wang, Yiting
9d1db41f-7eab-4e56-91f0-a95bb8c16ab0
Lange, Jeff L.
6814e919-75c2-4bfc-9a97-1ee3640e164b
Russell, R. Graham
aff1faf0-6fa7-4a26-beba-f72e9d03982c
Pazianas, Michael, Cooper, Cyrus, Wang, Yiting, Lange, Jeff L. and Russell, R. Graham
(2011)
Atrial fibrillation and the use of oral bisphosphonates.
Therapeutics and Clinical Risk Management, 7, .
(doi:10.2147/TCRM.S17899).
(PMID:21479144)
Abstract
Background: Epidemiological studies investigating a possible association between bisphosphonates and atrial fibrillation (AF) have reported conflicting findings. The objective of our study was to determine whether exposure to oral nitrogen-containing bisphosphonates alendronate and risedronate are associated with increased incidence of atrial fibrillation.
Methods: In a retrospective cohort study we analyzed data from three large independent databases, two from the United States (MarketScan® and Ingenix®) and one from the United Kingdom (THIN). 144,548 women, age 50–89, bisphosphonate users during 2002–2005 were compared to 668,891 sex- and age-matched controls (1:4). Our primary outcome measure was new incident atrial fibrillation for up to three years; Cox models adjusted for disease and drug history were used to estimated relative risks.
Results: We identified a total of 8,001, 1,984, and 817 AF cases in oral bisphosphonate users and nonusers during 744,340 (MarketScan), 243,898 (Ingenix), and 148,779 (THIN) person-years of follow-up, respectively. Compared to nonusers, overall adjusted relative risk (adjRR) (95% confidence interval [CI]) for AF in oral bisphosphonates users was 0.92 (0.85–0.99; MarketScan), 1.00 (0.87–1.16; Ingenix), and 0.97 (0.79–1.20; THIN); overall adjRR (95% CI) for any cardiac dysrrhythmia for MarketScan was 1.01 (0.98–1.05), Ingenix 1.06 (0.99–1.13), and THIN 0.97 (0.79–1.20).
Conclusions: In all three databases from the two countries, the risk of AF or cardiac dysrrhythmia was not increased in postmenopausal women treated for up to three years with oral alendronate or risedronate.
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Published date: March 2011
Keywords:
atrial fibrillation, chemically induced osteoporosis, drug therapy, alendronate or risedronate, bisphosphonates, adverse effects
Identifiers
Local EPrints ID: 186341
URI: http://eprints.soton.ac.uk/id/eprint/186341
ISSN: 1176-6336
PURE UUID: 87b9a0d7-c219-4cfd-8e2b-3098979aa4ef
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Date deposited: 13 May 2011 08:31
Last modified: 18 Mar 2024 02:45
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Author:
Michael Pazianas
Author:
Yiting Wang
Author:
Jeff L. Lange
Author:
R. Graham Russell
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