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Osteoporosis International

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01-04-2018 | Original Article

Acetylcholinesterase inhibitors and the risk of osteoporotic fractures: nested case-control study

Authors: I. Tamimi, B. Nicolau, H. Eimar, S. Arekunnath Madathil, A. Kezouh, I. Karp, F. Tamimi

Published in: Osteoporosis International | Issue 4/2018

Abstract

Summary

The objective of this study was to analyze the effect of acetylcholinesterase inhibitors (AChEIs) on the risk of osteoporotic fractures in Alzheimer patients. A nested case-control study was conducted on 1190 cases and 4760 controls. The use of AChEIs was found to decrease the risk of osteoporotic fractures in these patients.

Introduction

The objective of this study is to estimate the extent to which the use of AChEIs is associated with a reduction in the risk of osteoporotic fractures.

Methods

A nested case-control study was conducted using data from the UK Clinical Practice Research Datalink (CPRD) and Hospital Episode Statistics (HES) database (1998–2013). The study cohort consisted of Alzheimer’s Disease (AD) patients aged ≥ 65 years with no previous history of osteoporotic fractures at cohort baseline. Cases were individuals who suffered an osteoporotic fracture during the study period, whereas controls were subject who did not experience any osteoporotic fractures during the same period. Controls were drawn from the population time at risk while being matched to the cases in respect to age, sex, up-to-standard follow-up in the CPRD, calendar time, and duration of AD (control-to-case ratio: 4-to-1). Information on the use of AChEIs and the relevant potential confounders was ascertained from the CPRD database for all the cases and controls.

Results

We identified 1190 cases and 4760 controls. Compared to non-users, any use of AChEIs prior to the fracture was associated with a reduction in the fracture risk [adjusted odds ratio (OR) 0.80 (confidence interval (CI) 95%, 0.70–0.91)]. The use of AChEIs corresponding to a proportion of days covered of 0.8–1.0 was associated with a lower osteoporotic fracture risk compared to non-use [adjusted OR 0.76 (CI 95%, 0.66–0.87)].

Conclusions

In this study using large primary care databases, the use and treatment adherence to AChEIs were associated with a decreased risk of osteoporotic fractures in elderly AD patients.

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Title: Acetylcholinesterase inhibitors and the risk of osteoporotic fractures: nested case-control study
Authors: I. Tamimi
B. Nicolau
H. Eimar
S. Arekunnath Madathil
A. Kezouh
I. Karp
F. Tamimi
Publication date: 01-04-2018
Publisher: Springer London
Published in: Osteoporosis International / Issue 4/2018
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-017-4346-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Acetylcholinesterase inhibitors and the risk of osteoporotic fractures: nested case-control study

Abstract

Summary

Introduction

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Summary

Introduction

Methods

Results

Conclusions

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