Antidepressant medications in women aged 40 and older and the risk of fragility fractures: a systematic literature review and meta-analysis.

IF 2.5 3区医学 Q3 PHARMACOLOGY & PHARMACY

Expert Opinion on Pharmacotherapy Pub Date : 2024-10-01 Epub Date: 2024-10-03 DOI:10.1080/14656566.2024.2409316

Dana Alsugeir, Merit John, Emma Tillyer, Li Wei, Ruth Brauer

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引用次数: 0

Abstract

Introduction: Antidepressants and menopause are risk factors which are independently associated with an increased risk of fractures. This review aims to investigate the risk of fragility fractures in women aged 40 and older and prescribed antidepressants.

Methods: A literature search was conducted using PubMed, Ovid Embase, Ovid PsychINFO, Web of Science, and Scopus from inception to 1 June 2024. Relevant citations were identified and screened against our inclusion/exclusion criteria. The study population comprised women over 40 years. The risk of fragility fractures was compared between users and non-users of antidepressants. Risk of bias assessment was carried out using the ROBINS-I tool. A meta-analysis of cohort studies was performed to assess fracture risk associated with prescribing of any antidepressant agents, and SSRIs specifically.

Results: Of the 3,676 articles retrieved, five observational studies were found eligible for inclusion (n = 1,240,354). In a meta-analysis of 4 studies, an increased risk of fractures in women was associated with the prescribing of antidepressants (HR = 1.62, 95% CI: 1.15-2.28; I² = 96.50%) and SSRIs in particular (HR = 1.36, 95% CI: 1.20-1.55; I² = 40.32%).

Conclusions: Findings from this review suggest that prescribing of antidepressants is associated with an increased risk of fractures in women aged 40 and older. Substantial heterogeneity between studies may have affected the results of the meta-analysis.

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40 岁及以上女性服用抗抑郁药物与脆性骨折风险：系统文献综述和荟萃分析。

简介抗抑郁药和更年期是导致骨折风险增加的风险因素。本综述旨在调查 40 岁及以上女性服用抗抑郁药后发生脆性骨折的风险：方法：使用 PubMed、Ovid Embase、Ovid PsychINFO、Web of Science 和 Scopus 对从开始到 2024 年 6 月 1 日的文献进行检索。根据我们的纳入/排除标准确定并筛选了相关引文。研究对象包括 40 岁以上的女性。比较了服用和未服用抗抑郁药物者发生脆性骨折的风险。使用 ROBINS-I 工具对偏倚风险进行了评估。对队列研究进行了荟萃分析，以评估与任何抗抑郁药物处方相关的骨折风险，特别是与SSRIs相关的骨折风险：在检索到的 3,676 篇文章中，有五项观察性研究符合纳入条件（n = 1,240,354）。在对 4 项研究的荟萃分析中，女性骨折风险的增加与抗抑郁药处方有关（HR = 1.62，95% CI：1.15 - 2.28；I2 = 96.50%），尤其是 SSRIs（HR = 1.36，95% CI：1.20 - 1.55；I2 = 40.32%）：本综述的研究结果表明，抗抑郁药物的处方与 40 岁及以上女性骨折风险的增加有关。研究之间存在的巨大异质性可能会影响荟萃分析的结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Opinion on Pharmacotherapy 医学-药学

CiteScore

5.60

自引率

3.10%

发文量

163

审稿时长

4-8 weeks

期刊介绍： Expert Opinion on Pharmacotherapy is a MEDLINE-indexed, peer-reviewed, international journal publishing review articles and original papers on newly approved/near to launch compounds mainly of chemical/synthetic origin, providing expert opinion on the likely impact of these new agents on existing pharmacotherapy of specific diseases.