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Zeitschrift für Gerontologie und Geriatrie

Erschienen in:

01.08.2012 | Beiträge zum Themenschwerpunkt

Osteoporosis and polypharmacy

verfasst von: Mag. Dr. M. Gosch, MAS, M. Jeske, C. Kammerlander, T. Roth

Erschienen in: Zeitschrift für Gerontologie und Geriatrie | Ausgabe 6/2012

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Abstract

Osteoporosis is very common in elderly patients. Despite the severe health-related consequences for individual patients and the socioeconomic costs caused by osteoporotic fractures, treatment rates are still low. Due to drug interactions and patient compliance, polypharmacy is often mentioned as a reason for undertreatment. Several drugs have a direct or indirect effect on bone metabolism. The present paper discusses the risk of interactions of anti-osteoporotic drugs (oral and parenteral bisphosphonates, raloxifene, strontium ranelate, teriparatide, and denosumab) with other common medications in elderly patients and their impact on bone metabolism and fracture risk. In summary, the number and risk of drug interactions of all common anti-osteoporotic drugs are small and clinically rather irrelevant. However, patients with a polypharmacy are at a higher risk of fractures and should receive osteoporosis treatment, if indicated.

Vorheriger Artikel Polypharmazie im Fokus der Geriatrie

Nächster Artikel Aufbau und Ergebnisse einer geriatrischen Medikamentendatenbank

Leung F, Blauth M, Bavonratanavech S (2010) Surgery for fracture—streamlining the process. Osteoporos Int 21(Suppl 4):519–552CrossRef

Bartl R (2008) Osteoporose – Prävention – Diagnostik – Therapie. Georg Thieme, Stuttgart-New York, pp 1–2

Becker C, Gebhard F, Muche R et al (1999) Epidemiologie der Stürze Älterer. Z Orthop 137:482–485PubMedCrossRef

Häussler B, Gothe H, Göl D et al (2007) Epidemiology, treatment and costs of osteoporosis in Germany-the BoneEVA Study. Osteoporos Int 18:77–84PubMedCrossRef

Kammerlander C, Gosch M, Kammerlander-Knauer U et al (2011) Long-term functional outcome in geriatric hip fracture patients. Arch Orthop Trauma Surg 131:1435–1444PubMedCrossRef

Jennings LA, Auerbach AD, Maselli J et al (2010) Missed opportunities for osteoporosis treatment in patients hospitalized for hip fracture. J Am Geriatr Soc 58:650–657PubMedCrossRef

Kuijpers MA, Marum RJ van, Egberts AC et al (2008) Relationship between polypharmacy and underprescribing. Br J Clin Pharmacol 65:130–133PubMedCrossRef

Gosch M, Roth T, Kammerlander C et al (2011) Treatment of osteoporosis in postmenopausal hip fracture patients after geriatric rehabilitation: changes over the last decade. Z Gerontol Geriatr 44:381–386PubMedCrossRef

Solomon DH, Brookhart MA, Tsao P et al (2011) Predictors of very low adherence with medications for osteoporosis: towards development of a clinical prediction rule. Osteoporos Int 22:1737–1743PubMedCrossRef

10.

Kirigaya D, Nakayama T, Ishizaki T et al (2011) Management and treatment of osteoporosis in patients receiving long-term glucocorticoid treatment: current status of adeherence to clinical guidelines and related factors. Intern Med 50:2793–2800PubMedCrossRef

11.

Reid IR, Heap SW (1990) Determinants of vertebral mineral density in patients receiving long-term glucocorticoid therapy. Arch Intern Med 150:2545–2548PubMedCrossRef

12.

Van Staa TP, Leufkens HG, Cooper C (2002) The epidemiology of cortisteroid-induced osteoporosis: a meta-analysis. Osteoporos Int 13:777–787CrossRef

13.

Rejnmark L, Vestergaard P, Heickendorff L et al (2006) Loop diuretics increase bone turnover and decrease BMD in osteopenic postmenopausal women: results from a randomized controlled study with bumetanide. J Bone Miner Res 21:163–170PubMedCrossRef

14.

Heidrich FE, Stergachis A, Gross KM (1991) Diuretic drug use and the risk for hip fracture. Ann Intern Med 115:1–6PubMed

15.

Lim LS, Fink HA, Blackwell T et al (2009) Loop diuretic use and rates of hip bone loss and risk of falls and fractures in older women. J Am Geriatr Soc 57:855–862PubMedCrossRef

16.

Verdel BM, Souverein PC, Egberts TC et al (2010) Use of antidepressant drugs and risk of osteoporotic and non-osteoporotic fractures. Bone 47:604–609PubMedCrossRef

17.

Haney EM, Chan BK, Diem SJ et al (2007) Association of low bone mineral density with selective serotonin reuptake inhibitor use by older men. Arch Intern Med 167:1246–1251PubMedCrossRef

18.

Richards JB, Papaioannou A, Adachi JD et al (2007) Effect of selective serotonin reuptake inhibitors on the risk of fracture. Arch Intern Med 167:188–194PubMedCrossRef

19.

Haney EM, Warden SJ, Bliziotes MM (2010) Effects of selective serotonin reuptake inhibitors on bone health in adults: time for recommendations about screening, prevention and management? Bone 46:13–17PubMedCrossRef

20.

Gajic-Veljanoski O, Bayoumi AM, Tomlinson G et al (2012) Vitamin K supplementation for the primary prevention of osteoporotic fractures: is it cost-effective and is future research warranted? Osteoporos Int (Epub ahead of print)

21.

Philip WJ, Martin JC, Richardson JM et al (1995) Decreased axial and peripheral bone density in patients taking long-term warfarin. QJM 88:635–640PubMed

22.

Gage BF, Birman-Deych E, Radford MJ et al (2006) Risk of osteoporotic fracture in elderly patients taking warfarin: results from the National Registry of Atrial Fibrillation 2. Arch Intern Med 166:241–246PubMedCrossRef

23.

Barbour LA, Kick SD, Steiner JF et al (1994) A prospective study of heparin-induced osteoporosis in pregnancy using bone densitometry. Am J Obstet Gynecol 170:862–869PubMed

24.

Dahlman TC (1993) Osteoporotic fractures and the recurrence of thromboembolism during pregnancy and the puerperium in 184 women undergoing thromboprophylaxis with heparin. Am J Obstet Gynecol 168:1265–1270PubMed

25.

Pettilä V, Leinonen P, Markkola A et al (2002) Postpartum bone mineral density in women treated for thromboprophylaxis with unfractionated heparin or LMW heparin. Thromb Haemost 87:182–186PubMed

26.

Ross FP (2006) M-CSF, c-Fms, and signaling in osteoclasts and their precursors. Ann N Y Acad Sci 1068:110–116PubMedCrossRef

27.

Leese GP, Jung RT, Guthrie C et al (1992) Morbidity in patients on L-thyroxine: a comparison of those with a normal TSH to those with a suppressed TSH. Clin Endocrinol (Oxf) 37:500–503

28.

Faber J, Galløe AM (1994) Changes in bone mass during prolonged subclinical hyperthyroidism due to L-thyroxine treatment: a meta-analysis. Eur J Endocrinol 130:350–356PubMedCrossRef

29.

O’Connell MB, Madden DM, Murray AM et al (2005) Effects of proton pump inhibitors on calcium carbonate absorption in women: a randomized crossover trial. Am J Med 118:778–781CrossRef

30.

Serfaty-Lacrosniere C, Wood RJ, Voytko D et al (1995) Hypochlorhydria from short-term omeprazole treatment does not inhibit intestinal absorption of calcium, phosphorus, magnesium or zinc from food in humans. J Am Coll Nutr 14:364–368PubMed

31.

Yang YX, Lewis JD, Epstein S, Metz DC (2006) Long-term proton pump inhibitor therapy and risk of hip fracture. JAMA 296:2947–2953PubMedCrossRef

32.

Laine L (2009) Proton pump inhibitors and bone fractures? Am J Gastroenterol 104(Suppl 2):21–26CrossRef

33.

Gray SL, LaCroix AZ, Larson J et al (2010). Proton pump inhibitor use, hip fracture, and change in bone mineral density in postmenopausal women: results from the Women’s Health Initiative. Arch Intern Med 170:765–771PubMedCrossRef

34.

Zaidi M (1990) Modularity of osteoclast behaviour and “mode-specific” inhibition of osteoclast function. Biosci Rep 10:547–556PubMedCrossRef

35.

Heikkinen S, Auwerx J, Argmann CA (2007) PPARgamma in human and mouse physiology. Biochim Biophys Acta 1771:999–1013PubMedCrossRef

36.

Grey A (2008) Skeletal consequences of thiazolidinedione therapy. Osteoporos Int 19:129–137PubMedCrossRef

37.

Kahn SE, Zinman B, Lachin JM et al (2008) Rosiglitazone-associated fractures in type 2 diabetes: an Analysis from A Diabetes Outcome Progression Trial (ADOPT). Diabetes Care 31:845–851PubMedCrossRef

38.

Motola D, Piccinni C, Biagi C et al (2012) Cardiovascular, ocular and bone adverse reactions associated with thiazolidinediones: a disproportionality analysis of the US FDA adverse event reporting system database. Drug Saf 35:315–323PubMedCrossRef

39.

Meier C, Kraenzlin ME, Bodmer M et al (2008) Use of thiazolidinediones and fracture risk. Arch Intern Med 168:820–825PubMedCrossRef

40.

Eastell R, Hannon RA, Cuzick J et al (2006) Effect of an aromatase inhibitor on bmd and bone turnover markers: 2-year results of the Anastrozole, Tamoxifen, Alone or in Combination (ATAC) trial (18233230). J Bone Miner Res 21:1215–1223PubMedCrossRef

41.

Howell A (2005) Adjuvant aromatase inhibitors for breast cancer. Lancet 366:431–433PubMedCrossRef

42.

Bartl R, Bartl C, Gradinger R (2009) Drug-induced osteopathies. Drugs, pathogenesis, forms, diagnosis, prevention and therapy. Orthopade 38:1245–1260PubMedCrossRef

43.

Vestergaard P, Hermann P, Jensen JE et al (2012) Effects of paracetamol, non-steroidal anti-inflammatory drugs, acetylsalicylic acid, and opioids on bone mineral density and risk of fracture: results of the Danish Osteoporosis Prevention Study (DOPS). Osteoporos Int 23:1255–1265PubMedCrossRef

44.

Gosch M (2003) Are statins of value in therapy of osteoporosis? Wien Med Wochenschr 153:255–257PubMedCrossRef

45.

LaCroix AZ, Cauley JA, Pettinger M et al (2003) Statin use, clinical fracture, and bone density in postmenopausal women: results from the Women’s Health Initiative Observational Study. Ann Intern Med 139:97–104PubMed

46.

LaCroix AZ, Ott SM, Ichikawa L et al (2000) Low-dose hydrochlorothiazide and preservation of bone mineral density in older adults. A randomized, double-blind, placebo-controlled trial. Ann Intern Med 133:516–526PubMed

47.

Graham S, Hammond-Jones D, Gamie Z et al (2008) The effect of beta-blockers on bone metabolism as potential drugs under investigation for osteoporosis and fracture healing. Expert Opin Investig Drugs 17:1281–1299PubMedCrossRef

48.

Togari A, Arai M, Kondo A (2005) The role of the sympathetic nervous system in controlling bone metabolism. Expert Opin Ther Targets 9:931–940PubMedCrossRef

49.

Pasco JA, Henry MJ, Sanders KM et al (2004) Beta-adrenergic blockers reduce the risk of fracture partly by increasing bone mineral density: Geelong Osteoporosis Study. J Bone Miner Res 19:19–24PubMedCrossRef

50.

Laroche ML, Charmes JP, Nouaille Y et al (2007) Is inappropriate medication use a major cause of adverse drug reactions in the elderly? Br J Clin Pharmacol 63:177–186PubMedCrossRef

51.

Mannesse CK, Derkx FH, Ridder MA de et al (2000) Contribution of adverse drug reactions to hospital admission of older patients. Age Ageing 29:35–39PubMedCrossRef

52.

Woolcott JC, Richardson KJ, Wiens MO et al (2009) Meta-analysis of the impact of 9 medication classes on falls in elderly persons. Arch Intern Med 169:1952–1960. (Review. Erratum in: Arch Intern Med 2010 170:477)

Titel: Osteoporosis and polypharmacy
verfasst von: Mag. Dr. M. Gosch, MAS
M. Jeske
C. Kammerlander
T. Roth
Publikationsdatum: 01.08.2012
Verlag: Springer-Verlag
Erschienen in: Zeitschrift für Gerontologie und Geriatrie / Ausgabe 6/2012
Print ISSN: 0948-6704
Elektronische ISSN: 1435-1269
DOI: https://doi.org/10.1007/s00391-012-0374-7

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