Producción CientíficaPurpose 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 treat-
ments are not fully protected by bisphosphonates, which may imply the need for more potent anti-osteoporotic drugs such
as denosumab or teriparatide.Publicación en abierto financiada por el Consorcio de Bibliotecas Universitarias de Castilla y León (BUCLE), con cargo al Programa Operativo 2014ES16RFOP009 FEDER 2014-2020 DE CASTILLA Y LEÓN, Actuación:20007-CL - Apoyo Consorcio BUCL
