Gastrointestinal Events Among Patients Initiating Osteoporosis Therapy: A Retrospective Administrative Claims Database Analysis

Modi, Ankita; Siris, Ethel S.; Fan, Chun‐Po Steve; Sajjan, Shiva

doi:10.1016/j.clinthera.2015.03.018

Cited by 14 publications

(13 citation statements)

References 26 publications

(27 reference statements)

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“…CDM has been used to examine pharmacotherapy and health services in previous studies. 23,24,25,26 Individuals are enrolled in this insurance program under either health maintenance organizations, preferred provider organizations, point of services, or exclusive provider organizations. For each of these plans, providers are required to submit complete claims to receive reimbursement.…”

Section: Methodsmentioning

confidence: 99%

Predictors of Long-term Opioid Use Following Lumbar Fusion Surgery

Connolly

Javed

Raji

et al. 2017

Spine

120

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Study Design A population-based retrospective cohort study. Objective The aim of this study was to examine risk factors for long-term opioid use following lumbar spinal fusion surgery in a nationally representative cohort of commercially insured adults. Summary of Background Data Opioid prescription rates for the management of low back pain have more than doubled in the US over the past decade. Although opioids are commonly used for the management of pain following lumbar spinal fusion surgery, to date, no large-scale nationally representative studies have examined the risk factors for long-term opioid use following such surgical intervention. Methods Using one of the nation’s largest commercial insurance databases, we conducted a retrospective cohort study of 8,377 adults, aged 21–63 years, who underwent lumbar spinal fusion surgery between January 1, 2009 and December 31, 2012. Long-term opioid use was defined as ≥365 days of filled opioid prescriptions in the 24 months following lumbar fusion. Multivariable logistic regression was used to calculate adjusted odds ratios (ORs) and 95% confidence intervals for the risk of long term opioid use following lumbar fusion. Results After adjusting for covariates, the following factors were associated with an increased risk of long term opioid use following surgery: duration of opioid use in the year before lumbar surgery [Referent (0 days); Quartile 1 (1–22 days) OR=2.27, 95% CI=1.48–3.49; Quartile 2(23–72 days): OR=5.94, 95% CI=4.00–8.83; Quartile 3: (73–250 days) OR=25.31, 95% CI=17.26–37.10; Quartile 4 (≥ 250days) OR=219.95, 95% CI=148.53–325.71 )], re-fusion surgery (OR=1.32, 95% CI=1.02–1.72), and diagnosis of depression (OR=1.43, 95% CI=1.18–1.74). Receipt of anterior fusion was associated with a modest decrease in the risk of long-term opioid use (OR=0.79, 95% CI=0.63–0.99). Conclusions These findings may provide clinically relevant information to physicians, patients, and their families regarding the risk factors for opioid dependence following lumbar fusion surgery.

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Section: Methodsmentioning

confidence: 99%

Predictors of Long-term Opioid Use Following Lumbar Fusion Surgery

Connolly

Javed

Raji

et al. 2017

Spine

120

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“…Oral BPs are associated with upper gastrointestinal tract adverse effects in about 25% of the patients [8]. GI adverse reactions include problems such as heartburn, nausea, vomiting, epigastric pain, esophagitis, gastric ulcer and dyspepsia; 0.9% of patients require hospitalization due to Downloaded by [University of California, San Diego] at 12: 44 30 December 2015 gastrointestinal bleeding [9].…”

Section: Gastrointestinal Side Effectsmentioning

confidence: 99%

Safety issues and adverse reactions with osteoporosis management

Rossini¹,

Adami²,

Adami³

et al. 2016

Expert Opinion on Drug Safety

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The safety profile of most available drugs for the treatment of osteoporosis is well defined and the most serious adverse events are either rare or predictable. Osteoporosis treatment is a favorable choice in patients at moderate-high risk of fracture, while in patients at low risk pharmacological prevention should involve consideration of the balance between the beneficial effects of treatment, the probability of adverse effects and costs.

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“…Fosamax intake may be associated also with gastrointestinal events as erosive esophagitis, gastritis, duodenitis, ulceration, stricture and gastrointestinal perforation. Moreover, hemorrhage due to esophageal, gastric, duodenal or peptic ulcers may occur [4,5,6,7] . It has been reported that bisphosphonates differ in their potential to damage the mucosa, alendronate having a higher potential for such effect.…”

Section: Introductionmentioning

confidence: 99%

Effect of Fosamax on the duodenal mucosa in adult male albino rats and the possible protection by nigella sativa oil: a histological and immunohistochemical study

Kassab

2019

Egyptian Journal of Histology

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Background: Fosamax, an oral bisphosphonate, is the most commonly prescribed drug for the treatment of various bones diseases. However, Fosamax therapy is associated with gastrointestinal toxicity that influences the treatment compliance. Nigella sativa (N sativa) is an annual herbaceous plant and have been safely used as a natural remedy in Egypt. It has a wide range of pharmacological activities and a proposed role in combating many gastrointestinal disorders. Aim: This work aimed to study the effect of Fosamax on the histological structure of the duodenal mucosa of albino rats and to evaluate the possible protective role of nigella sativa oil. Materials and methods: Forty adult male albino rats were divided into four equal groups: the control group, the N sativa oil-treated group (2.5 ml/kg), the Fosamax-treated group (0.05mg/kg), and both Fosamax and N sativa oil-treated group. Treatments were given orally once weekly for 13 weeks. Specimens from the duodenum were processed for light microscopy. Immunohistochemical study was carried out using antibodies against nuclear factor-κB (NF-κB), cyclooxygenase-2 (COX-2), B-cell lymphoma 2 (Bcl-2), Bcl-2-associated X protein (Bax) and Ki67 protein. Results: Specimens from Fosamax-treated rats showed a statistically significant decrease in the duodenal mucosal thickness. The lining epithelium showed nuclear alteration and vacuolated cytoplasm and there was mononuclear cellular infiltration. The immunohistochemical study of Fosamax-treated group showed a significant increase in NF-kB, COX-2 and Bax immunoreaction and a significant decrease in Bcl-2 and Ki67 expression. In contrast, minimal changes were observed in rats treated concomitantly with both Fosamax and N sativa oil with non-significant changes in the immunoreactions compared with the control group. Conclusion: Fosamax induced structural changes in the duodenal mucosa of adult albino rats, which could be ameliorated by concomitant treatment with nigella sativa oil.

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Gastrointestinal Events Among Patients Initiating Osteoporosis Therapy: A Retrospective Administrative Claims Database Analysis

Cited by 14 publications

References 26 publications

Predictors of Long-term Opioid Use Following Lumbar Fusion Surgery

Predictors of Long-term Opioid Use Following Lumbar Fusion Surgery

Safety issues and adverse reactions with osteoporosis management

Effect of Fosamax on the duodenal mucosa in adult male albino rats and the possible protection by nigella sativa oil: a histological and immunohistochemical study

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