1. Oral bisphosphonates do not increase the risk of severe upper gastrointestinal complications: a nested case–control study
- Author
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Ghirardi, Arianna, Scotti, Lorenza, Vedova, Gianluca D., D'Oro, Luca C., Lapi, Francesco, Cipriani, Francesco, Caputi, Achille P., Vaccheri, Alberto, Gregori, Dario, Gesuita, Rosaria, Vestri, Annarita, Staniscia, Tommaso, Mazzaglia, Giampiero, Corrao, Giovanni, Sessa, E., Arcoraci, V., Parodi, A., Zambon, A., Montanaro, N., Piccinni, C., Suzzi, C., Puccini, A., Sturkenboom, M., Geppetti, P., Sati, L., Di Bari, M., Forlan, F., Carle, F., Menna, A., Valenti, M., Ghirardi A, Scotti L, Vedova GD, D'Oro LC, Lapi F, Cipriani F, Caputi AP, Vaccheri A, Gregori D, Gesuita R, Vestri A, Staniscia T, Mazzaglia G, Corrao G, AIFA-BEST Investigators, Ghirardi, A, Scotti, L, DELLA VEDOVA, G, D'Oro, L, Lapi, F, Cipriani, F, Caputi, A, Vaccheri, A, Gregori, D, Gesuita, R, Vestri, A, Staniscia, T, Mazzaglia, G, Corrao, G, AIFA BEST, I, and Medical Informatics
- Subjects
Male ,Gastrointestinal Diseases ,Administration, Oral ,Comorbidity ,Risk Factors ,80 and over ,Secondary Prevention ,Drug safety ,Aged, 80 and over ,Bone Density Conservation Agents ,Diphosphonates ,Incidence ,Incidence (epidemiology) ,Gastroenterology ,Bisphosphonates ,General Medicine ,Middle Aged ,Calcium Channel Blockers ,Italy ,Administration ,Cohort ,Upper gastrointestinal complications ,Nested case-control ,Female ,Research Article ,Oral ,Healthcare utilization database ,medicine.medical_specialty ,Database ,Fracture prevention ,Internal medicine ,medicine ,Humans ,Bisphosphonate ,MED/01 - STATISTICA MEDICA ,Aged ,business.industry ,Case-control study ,Case-Control Studies ,Hydroxymethylglutaryl-CoA Reductase Inhibitors ,Osteoporotic Fractures ,Odds ratio ,medicine.disease ,Confidence interval ,Surgery ,Regimen ,Nested case-control study ,Bisphosphonates, Drug safety, Healthcare utilization database, Upper gastrointestinal complications ,Osteoporosis ,healthcare utilization database ,upper gastrointestinal complications ,drug safety ,bisphosphonates ,business - Abstract
Background Data on the effect of oral bisphosphonates (BPs) on risk of upper gastrointestinal complications (UGIC) are conflicting. We conducted a large population-based study from a network of Italian healthcare utilization databases aimed to assess the UGIC risk associated with use of BPs in the setting of secondary prevention of osteoporotic fractures. Methods A nested case–control study was carried out within a cohort of 68,970 patients aged 45 years or older, who have been hospitalized for osteoporotic fracture from 2003 until 2005. Cases were the 804 patients who experienced hospitalization for UGIC until 2007. Up to 20 controls were randomly selected for each case. Conditional logistic regression model was used to estimate odds ratio (OR) associated with current and past use of BPs (i.e. for drug dispensation within 30 days and over 31 days prior the outcome onset, respectively) after adjusting for several covariates. Results Compared with patients who did not use BPs, current and past users had OR (and 95% confidence interval) of 0.86 (0.60 to 1.22) and 1.07 (0.80 to 1.44) respectively. There was no difference in the ORs estimated according with BPs type (alendronate or risedronate) and regimen (daily or weekly), nor with co-therapies and comorbidities. Conclusions Further evidence that BPs dispensed for secondary prevention of osteoporotic fractures are not associated with increased risk of severe gastrointestinal complications is supplied from this study. Further research is required to clarify the role BPs and other drugs of co-medication in inducing UGIC.
- Published
- 2014