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European Journal of Clinical Pharmacology

, Volume 75, Issue 12, pp 1705–1711 | Cite as

Drug-induced osteoporosis/osteomalacia: analysis in the French and Spanish pharmacovigilance databases

  • Quentin Dardonville
  • Esther Salguiero
  • Vanessa Rousseau
  • Leila Chebane
  • Jean Luc Faillie
  • Sophie Gautier
  • Jean Louis Montastruc
  • Alfonso Carvajal
  • Haleh BagheriEmail author
Pharmacoepidemiology and Prescription

Abstract

Introduction

Osteomalacia and osteoporosis are two metabolic bone disorders that increase the risk of fracture due to several causes. In terms of drugs, apart from corticosteroids, which are known to induce bone disorders, several other drugs used in chronic disease management have also been linked with an increased risk of osteoporosis and osteomalacia.

Purpose

The aim of this study was to describe spontaneous reports of drug-induced osteoporosis and osteomalacia in the French (FPVDB) and Spanish (SPVDB) pharmacovigilance databases.

Methods

Data were provided by the FPVDB and SPVDB. All reports of osteoporosis and osteomalacia recorded from 1985 up to 31 December 2015 inclusive were selected. Taking the time to onset of bone loss into account, all cases occurring in less than 1 month were excluded.

Results

A total of 369 reports (44 cases of osteomalacia, 325 cases of osteoporosis) were registered in the FPVDB and 64 (22 cases of osteomalacia, 42 cases of osteoporosis) in the SPVDB. In France, the top 5 drugs involved in the onset of osteoporosis were corticosteroids accounting for approximately half of the reports (n = 170) followed by systemic antiviral (n = 87), antacid (n = 29), antiepileptic (n = 27) and antithrombotic (n = 24) drugs. The 2 main classes of drugs implicated in osteomalacia were systemic antiretroviral drugs for half of the reports (n = 21) and antiepileptic drugs (n = 15). In Spain, corticosteroids were involved in 35.7% of reported cases of osteoporosis (n = 15) followed by systemic antiviral drugs (n = 12). There was no spontaneous report for antacid drugs. For osteomalacia, the 2 main drug classes were systemic antiretroviral drugs (n = 18, 81.8%) followed by antiepileptics (n = 2, 9.0%). In both countries, concomitant administration of systemic corticosteroids with other suspected drugs did not significantly modify the time to onset of drug-induced osteoporosis.

Conclusion

Despite some differences between the French and Spanish PVDBs, our data consistently show that bone loss is not only restricted to glucocorticoids but also involves antivirals, antiepileptic drugs, antacid drugs or antidepressants. Further analysis might prove useful in exploring the characteristics of drug-induced bone loss on a larger scale.

Keywords

Osteoporosis Osteomalacia Adverse drug reactions Drug-induced bone loss 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Quentin Dardonville
    • 1
  • Esther Salguiero
    • 2
  • Vanessa Rousseau
    • 1
  • Leila Chebane
    • 1
  • Jean Luc Faillie
    • 3
  • Sophie Gautier
    • 4
  • Jean Louis Montastruc
    • 1
  • Alfonso Carvajal
    • 5
  • Haleh Bagheri
    • 1
    Email author
  1. 1.Service de Pharmacologie Médicale et Clinique, Centre de Pharmacovigilance, de Pharmacoépidémiologie et d’Informations sur le Médicament, INSERM U1027, Faculté de MédecineCentre Hospitalier UniversitaireToulouseFrance
  2. 2.Departamento de Medicina, Área de FarmacologíaUniversidad de OviedoOviedoSpain
  3. 3.Département de Pharmacologie Médicale et Toxicologie, Centre de PharmacovigilanceHospitalier UniversitaireMontpellierFrance
  4. 4.Centre Regional de Pharmacovigilance de Lille, UnivLille, INSERMCHU LilleLilleFrance
  5. 5.Centro de Estudios sobre la Seguridad de Medicamentos, School of MedicineUniversity of ValladolidValladolidSpain

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