Exposure to antiepileptic drugs and the risk of hip fracture: a case-control study

Ioannis Tsiropoulos, Morten Andersen, Tine Nymark, Jens Lauritsen, David Gaist, Jesper Hallas

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

PURPOSE: To investigate whether the use of antiepileptic drugs (AEDs) increases the risk of hip fracture. METHODS: We performed a case-control study using data from the Funen County (population 2004: 475,000) hip fracture register. Cases (n = 7,557) were all patients admitted to county hospitals with a hip fracture during the period 1996-2004. Controls (n = 27,575) were frequency matched by age and gender. Information on use of AEDs, other drugs, and hospital contacts was available from local registers. Odds ratios (ORs) with 95% confidence intervals (CI) for hip fracture were estimated by unconditional logistic regression. RESULTS: Fracture risk was increased with ever use of any AED (OR: 1.31; 95% CI: 1.16-1.48). The risk was also increased with use of only enzyme inducing (OR: 1.31; 95% CI: 1.14-1.51), but not with use of only noninducing AEDs (OR: 1.03; 95% CI: 0.77-1.37). Current (OR: 1.92; 95% CI: 1.58-2.33) and recent use, as well as high daily (OR: 1.50; 95% CI: 1.24-1.82) and cumulative dose increased fracture risk, but long treatment duration or previous use did not. The risk was modified by the presence of an epilepsy diagnosis. CONCLUSION: Use of AEDs modestly increases the risk of hip fracture. The risk increase is probably associated to a higher degree with a dose dependent effect on CNS with current and recent use, than with an effect on bone tissue.
Original languageEnglish
JournalEpilepsia
Volume49
Issue number12
Pages (from-to)2092-9
Number of pages7
ISSN0013-9580
DOIs
Publication statusPublished - 2008

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Case-Control Studies
Odds Ratio
Confidence Intervals
County Hospitals
Logistic Models
Enzymes
Pharmaceutical Preparations
Population

Cite this

@article{69ee5390d8c011dd9908000ea68e967b,
title = "Exposure to antiepileptic drugs and the risk of hip fracture: a case-control study",
abstract = "PURPOSE: To investigate whether the use of antiepileptic drugs (AEDs) increases the risk of hip fracture. METHODS: We performed a case-control study using data from the Funen County (population 2004: 475,000) hip fracture register. Cases (n = 7,557) were all patients admitted to county hospitals with a hip fracture during the period 1996-2004. Controls (n = 27,575) were frequency matched by age and gender. Information on use of AEDs, other drugs, and hospital contacts was available from local registers. Odds ratios (ORs) with 95{\%} confidence intervals (CI) for hip fracture were estimated by unconditional logistic regression. RESULTS: Fracture risk was increased with ever use of any AED (OR: 1.31; 95{\%} CI: 1.16-1.48). The risk was also increased with use of only enzyme inducing (OR: 1.31; 95{\%} CI: 1.14-1.51), but not with use of only noninducing AEDs (OR: 1.03; 95{\%} CI: 0.77-1.37). Current (OR: 1.92; 95{\%} CI: 1.58-2.33) and recent use, as well as high daily (OR: 1.50; 95{\%} CI: 1.24-1.82) and cumulative dose increased fracture risk, but long treatment duration or previous use did not. The risk was modified by the presence of an epilepsy diagnosis. CONCLUSION: Use of AEDs modestly increases the risk of hip fracture. The risk increase is probably associated to a higher degree with a dose dependent effect on CNS with current and recent use, than with an effect on bone tissue.",
author = "Ioannis Tsiropoulos and Morten Andersen and Tine Nymark and Jens Lauritsen and David Gaist and Jesper Hallas",
year = "2008",
doi = "10.1111/j.1528-1167.2008.01640.x",
language = "English",
volume = "49",
pages = "2092--9",
journal = "Epilepsia",
issn = "0013-9580",
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Exposure to antiepileptic drugs and the risk of hip fracture: a case-control study. / Tsiropoulos, Ioannis; Andersen, Morten; Nymark, Tine; Lauritsen, Jens; Gaist, David; Hallas, Jesper.

In: Epilepsia, Vol. 49, No. 12, 2008, p. 2092-9.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Exposure to antiepileptic drugs and the risk of hip fracture: a case-control study

AU - Tsiropoulos, Ioannis

AU - Andersen, Morten

AU - Nymark, Tine

AU - Lauritsen, Jens

AU - Gaist, David

AU - Hallas, Jesper

PY - 2008

Y1 - 2008

N2 - PURPOSE: To investigate whether the use of antiepileptic drugs (AEDs) increases the risk of hip fracture. METHODS: We performed a case-control study using data from the Funen County (population 2004: 475,000) hip fracture register. Cases (n = 7,557) were all patients admitted to county hospitals with a hip fracture during the period 1996-2004. Controls (n = 27,575) were frequency matched by age and gender. Information on use of AEDs, other drugs, and hospital contacts was available from local registers. Odds ratios (ORs) with 95% confidence intervals (CI) for hip fracture were estimated by unconditional logistic regression. RESULTS: Fracture risk was increased with ever use of any AED (OR: 1.31; 95% CI: 1.16-1.48). The risk was also increased with use of only enzyme inducing (OR: 1.31; 95% CI: 1.14-1.51), but not with use of only noninducing AEDs (OR: 1.03; 95% CI: 0.77-1.37). Current (OR: 1.92; 95% CI: 1.58-2.33) and recent use, as well as high daily (OR: 1.50; 95% CI: 1.24-1.82) and cumulative dose increased fracture risk, but long treatment duration or previous use did not. The risk was modified by the presence of an epilepsy diagnosis. CONCLUSION: Use of AEDs modestly increases the risk of hip fracture. The risk increase is probably associated to a higher degree with a dose dependent effect on CNS with current and recent use, than with an effect on bone tissue.

AB - PURPOSE: To investigate whether the use of antiepileptic drugs (AEDs) increases the risk of hip fracture. METHODS: We performed a case-control study using data from the Funen County (population 2004: 475,000) hip fracture register. Cases (n = 7,557) were all patients admitted to county hospitals with a hip fracture during the period 1996-2004. Controls (n = 27,575) were frequency matched by age and gender. Information on use of AEDs, other drugs, and hospital contacts was available from local registers. Odds ratios (ORs) with 95% confidence intervals (CI) for hip fracture were estimated by unconditional logistic regression. RESULTS: Fracture risk was increased with ever use of any AED (OR: 1.31; 95% CI: 1.16-1.48). The risk was also increased with use of only enzyme inducing (OR: 1.31; 95% CI: 1.14-1.51), but not with use of only noninducing AEDs (OR: 1.03; 95% CI: 0.77-1.37). Current (OR: 1.92; 95% CI: 1.58-2.33) and recent use, as well as high daily (OR: 1.50; 95% CI: 1.24-1.82) and cumulative dose increased fracture risk, but long treatment duration or previous use did not. The risk was modified by the presence of an epilepsy diagnosis. CONCLUSION: Use of AEDs modestly increases the risk of hip fracture. The risk increase is probably associated to a higher degree with a dose dependent effect on CNS with current and recent use, than with an effect on bone tissue.

U2 - 10.1111/j.1528-1167.2008.01640.x

DO - 10.1111/j.1528-1167.2008.01640.x

M3 - Journal article

C2 - 18479399

VL - 49

SP - 2092

EP - 2099

JO - Epilepsia

JF - Epilepsia

SN - 0013-9580

IS - 12

ER -