Osteoporosis International

, Volume 20, Issue 4, pp 585–597

Mapping the prescriptiome to fractures in men—a national analysis of prescription history and fracture risk

Original Article

DOI: 10.1007/s00198-008-0711-2

Cite this article as:
Abrahamsen, B. & Brixen, K. Osteoporos Int (2009) 20: 585. doi:10.1007/s00198-008-0711-2

Abstract

Summary

A nationwide case-control study was performed in 62,865 men aged 50+ using fracture data from the national hospital discharge register to screen all redeemed prescriptions in the past 5 years for significant mapping to fracture risk, employing measures to control for false discovery rate.

Introduction

Osteoporosis in men is frequently related to alcohol abuse, hypogonadism, hypercalciuria, or the use of glucocorticoids. Very limited information is available on the impact of other medications on fracture risk in men.

Methods

We conducted a nationwide population-based case-control study collecting fracture data from the Danish National Hospital Discharge Register and prescriptions from the National Prescriptions Database (1995–2000). We included men aged 50+ years, with hospital-treated fractures in the year 2000 (n = 15,716), and age- and sex-matched controls (n = 47,149).

Results

We identified 3.2 million redemptions of prescriptions for 1,073 different drugs. The analysis confirmed associations between fracture risk and use of sedatives, anti-epileptics, anti-psychotics, anxiolytics, SSRI, opioids and other analgesics, loop diuretics, and glucorticoids. New associations were also found. We observed an odds ratio (OR [95% CI] for any fracture) for fracture in users of dopaminergic agents (1.6 [1.3–1.9]) and iron compounds (1.2 [1.1–1.5]). The largest impact on fracture risk at population level was exerted by loop diuretics and analgesics.

Conclusions

An array of drugs is associated with fracture risk in men. The “prescriptiome” analysis can be used as a surveillance tool for drug-induced osteoporosis and in the planning of preventive measures.

Keywords

EpidemiologyFracture riskMenOsteoporosisPharmacoepidemiology

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2008

Authors and Affiliations

  1. 1.Department of Internal Medicine and EndocrinologyCopenhagen University Hospital GentofteCopenhagenDenmark
  2. 2.Department of EndocrinologyOdense University HospitalOdenseDenmark
  3. 3.Department of MedicineCopenhagen University Hospital GentofteCopenhagenDenmark