Association between ramelteon use and risk of fragility fractures: A retrospective cohort study.

IF 3.1 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM
Hitoshi Tange, Yoshihisa Miyamoto, Yusuke Sasabuchi, Hideo Yasunaga
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引用次数: 0

Abstract

The effect of melatonin receptor agonists on bone remains unclear. This retrospective cohort study provides the first evidence that the short- to mid-term use of ramelteon is not associated with the risk of fracture. Further research with longer follow-up is needed to clarify the effects of ramelteon on bone health.

Background: Recent studies have suggested that melatonin may have the potential to treat osteoporosis. However, few studies have examined the effects of melatonin receptor agonists on bone health. This study aimed to evaluate the association between ramelteon use and the risk of fragility fractures.

Methods: We conducted a retrospective cohort study from April 2014 to November 2022 using the DeSC database, a large healthcare claims database in Japan, employing an active comparator and new-user design. Female participants aged ≥ 50 years were included in the study. Exposure was defined as the first dispensation of ramelteon or orexin receptor antagonists. The outcome was a composite of major fragility fractures, including hip, vertebral, wrist, proximal humeral, and ankle fractures. To adjust for potential confounders, we used overlap weighting analysis with propensity scores. Cox regression analyses were performed both before and after applying overlap weighting.

Results: A total of 106,511 individuals were identified, including 23,312 new ramelteon users and 83,199 new orexin receptor antagonist users. The overall fracture incidence was 9,429 per 100,000 person-years in the ramelteon group and 7,330 per 100,000 person-years in the orexin receptor antagonist group. The adjusted hazard ratio for overall fractures associated with ramelteon use was 1.07 (95% confidence interval: 0.99-1.17). The results were consistent across fracture types, age groups, and landmark analyses.

Conclusions: In a real-world setting, short- to mid-term ramelteon use was not associated with an increased risk of fractures. Future studies should consider longer follow-up periods to further investigate the effects of ramelteon on bone health.

ramelteon使用与脆性骨折风险之间的关系:一项回顾性队列研究。
褪黑激素受体激动剂对骨骼的影响尚不清楚。这项回顾性队列研究首次提供了短期至中期使用拉美替恩与骨折风险无关的证据。需要进一步的研究和更长时间的随访来阐明ramelteon对骨骼健康的影响。背景:最近的研究表明,褪黑素可能有治疗骨质疏松症的潜力。然而,很少有研究检查褪黑激素受体激动剂对骨骼健康的影响。本研究旨在评估ramelteon使用与脆性骨折风险之间的关系。方法:2014年4月至2022年11月,我们使用日本大型医疗索赔数据库DeSC数据库进行了一项回顾性队列研究,采用主动比较者和新用户设计。年龄≥50岁的女性被纳入研究。暴露被定义为第一次分配rammelteon或食欲素受体拮抗剂。结果是主要脆性骨折的复合,包括髋部、椎体、腕部、肱骨近端和踝关节骨折。为了调整潜在的混杂因素,我们使用了倾向得分的重叠加权分析。应用重叠加权前后分别进行Cox回归分析。结果:共鉴定出106511人,其中包括23312名新的拉米替恩使用者和83199名新的食欲素受体拮抗剂使用者。ramelteon组骨折总发生率为9429 / 100000人年,而食欲素受体拮抗剂组为7330 / 100000人年。ramelteon使用相关整体骨折的校正风险比为1.07(95%可信区间:0.99-1.17)。结果在骨折类型、年龄组和里程碑分析中是一致的。结论:在现实环境中,短期至中期使用ramelteon与骨折风险增加无关。未来的研究应该考虑更长时间的随访,以进一步研究拉梅尔铁对骨骼健康的影响。
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来源期刊
Archives of Osteoporosis
Archives of Osteoporosis ENDOCRINOLOGY & METABOLISMORTHOPEDICS -ORTHOPEDICS
CiteScore
5.50
自引率
10.00%
发文量
133
期刊介绍: Archives of Osteoporosis is an international multidisciplinary journal which is a joint initiative of the International Osteoporosis Foundation and the National Osteoporosis Foundation of the USA. The journal will highlight the specificities of different regions around the world concerning epidemiology, reference values for bone density and bone metabolism, as well as clinical aspects of osteoporosis and other bone diseases.
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