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Effects of analgesics on bone mineral density: A longitudinal analysis of the prospective SWAN cohort with three‐group matching weights
Author(s) -
Yoshida Kazuki,
Yu Zhi,
Greendale Gail A.,
Ruppert Kristine,
Lian Yinjuan,
Tedeschi Sara K.,
Lin TzuChieh,
Haneuse Sebastien,
Glynn Robert J.,
HernándezDíaz Sonia,
Solomon Daniel H.
Publication year - 2018
Publication title -
pharmacoepidemiology and drug safety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.023
H-Index - 96
eISSN - 1099-1557
pISSN - 1053-8569
DOI - 10.1002/pds.4362
Subject(s) - medicine , propensity score matching , bone mineral , acetaminophen , opioid , prospective cohort study , femoral neck , longitudinal study , pharmacoepidemiology , repeated measures design , cohort , generalized estimating equation , cohort study , anesthesia , osteoporosis , medical prescription , statistics , pharmacology , receptor , mathematics , pathology
Purpose To examine the effects of analgesics on bone mineral density (BMD), which have not been examined in a longitudinal study with multiple measurements. Methods We investigated changes in BMD associated with new use of analgesics in a prospective longitudinal cohort of mid‐life women. BMD and medication use were measured annually. We compared BMD among new users of acetaminophen, NSAIDs, and opioids. Adjustment for baseline covariates was conducted through propensity score matching weights. On‐treatment analysis was conducted with inverse probability of censoring weights. Analysis based on the initial treatment group was also conducted to provide insights into selection bias. Repeated BMD measurements were examined with generalized estimating equations. Results We identified 71 acetaminophen new users, 659 NSAID new users, and 84 opioid new users among 2365 participants. In the on‐treatment analysis, the opioid group in comparison to the acetaminophen group had an additional average BMD decline of −0.06% [−1.24, 1.11] per year in the spine and −0.45% [−1.51, 0.61] per year in the femoral neck. BMD mean trajectories over time suggested a fifth‐year decline in the opioid persistent users compared with other 2 groups. In the initial treatment group analysis, all 3 groups showed similar trajectories. Conclusion The BMD decline over time was similar among the 3 groups. However, 5 years of continuous opioid use may be associated with a greater BMD decline than 5 years on other analgesics. Further studies examining the relationship between very long‐term persistent opioid use and BMD are warranted.