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)

Abstract

Significant differences exist between subjects exposed to pain medications and non-users. Despite an absence of an effect over time on BMD, users of NSAID experienced more fractures than expected. The reasons for this have to be explored in further studies.

The association of opioid use with incident lower extremity fractures in spinal cord injury

“…[13][14][15] It is possible that over time our patients partially adapted to the central nervous system effects from opioids that might contribute to falls over time, and that is why the fracture risk decreased over time with use of opioids. In support of this, in non-SCI populations, it has been reported that despite a trend for an increased risk of fractures in opioid users, there are no differences in BMD compared with non-opioid users, 44 although others report that BMD is decreased in opioid users compared with non-opioid users. 5,6 In accord with a report of patients without SCI given opioids, 7 we also found that higher doses of opioids were associated with an increased risk for fracture in patients with SCI.…”

“…In the non-SCI population, lower levels of vitamin D are seen in opioid users compared with non-users. 44 Our data only indicate whether an opioid was prescribed, not whether or not it was actually taken as prescribed. Women were excluded from our analyses because there were <1% (n = 26) women in our SCD registry data.…”

Acute and chronic pain in vertebral fractures as systemic osteoporosis complication. Literature review

“…Для купирования хронической боли рекомендуются курсы НПВП (при отсутствии противопоказаний со стороны желудочно-кишечного тракта) [30], но они оказывают нега-тивное влияние на костный метаболизм, поэтому их исполь-зование не может быть длительным [31].…”

NSAIDs and radiographic progression in ankylosing spondylitis Bagging big game with small arms?

“…None of these studies, however, showed a beneficial effect of NSAID use on preventing fractures. In fact, a subsequent study hinted at a possible increase in risk of fractures in NSAID users despite an increase in BMD 9. Analysis of the Canadian Multicentre Osteoporosis Study on the effects of NSAIDs on BMD led to interesting findings 10.…”