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Fracture risk associated with parkinsonism and anti-Parkinson drugs.
Calcif Tissue Int 2007; 81(3):153-61CT

Abstract

We studied fracture risk associated with parkinsonism (including Parkinson's disease) and drugs used to treat these conditions in a case-control study. Cases were all subjects with any fracture during the year 2000 (n = 124,655). For each case, three controls (n = 373,962) matched on age and gender were randomly drawn from the background population. Exposure was a diagnosis of parkinsonism or use of anticholinergic drugs, levodopa alone or in combination with carbidopa, and/or catechol-O-methyl transferase (COMT) inhibitors, dopamine agonists, or monoamine oxidase B (MAO-B) inhibitors and a number of other confounders. Parkinsonism was associated with a crude odds ratio (OR) of any fracture of 2.2 (95% confidence interval [95% CI] 2.0-2.5) and an adjusted OR of 1.2 (95% CI 1.0-1.4), the risk being higher especially in males younger than 75 years. Levodopa was associated with an increased overall fracture risk and an increased risk of hip fractures in high doses. Dopamine agonists, anticholinergic drugs, and MAO-B inhibitors were not associated with increased fracture risk except for hip fractures at high doses for MAO-B inhibitors and hip fractures at median doses for dopamine agonists. Neuroleptics were associated with increased risk of fractures in almost all skeletal sites and doses. In conclusion, parkinsonism was associated with increased risk of fractures, especially among males younger than 75 years, and the risk was significantly attenuated upon adjustment for confounders. Use of neuroleptics and, to some degree, levodopa was associated with increased risk of fractures.

Authors+Show Affiliations

Department of Endocrinology and Metabolism C, Aarhus Amtssygehus, Aarhus University Hospital, Tage Hansens Gade 2, DK-8000, Aarhus C, Denmark. p-vest@post4.tele.dkNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17705047

Citation

Vestergaard, Peter, et al. "Fracture Risk Associated With Parkinsonism and anti-Parkinson Drugs." Calcified Tissue International, vol. 81, no. 3, 2007, pp. 153-61.
Vestergaard P, Rejnmark L, Mosekilde L. Fracture risk associated with parkinsonism and anti-Parkinson drugs. Calcif Tissue Int. 2007;81(3):153-61.
Vestergaard, P., Rejnmark, L., & Mosekilde, L. (2007). Fracture risk associated with parkinsonism and anti-Parkinson drugs. Calcified Tissue International, 81(3), pp. 153-61.
Vestergaard P, Rejnmark L, Mosekilde L. Fracture Risk Associated With Parkinsonism and anti-Parkinson Drugs. Calcif Tissue Int. 2007;81(3):153-61. PubMed PMID: 17705047.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fracture risk associated with parkinsonism and anti-Parkinson drugs. AU - Vestergaard,Peter, AU - Rejnmark,Lars, AU - Mosekilde,Leif, Y1 - 2007/08/20/ PY - 2007/06/04/received PY - 2007/07/16/accepted PY - 2007/8/21/pubmed PY - 2007/11/14/medline PY - 2007/8/21/entrez SP - 153 EP - 61 JF - Calcified tissue international JO - Calcif. Tissue Int. VL - 81 IS - 3 N2 - We studied fracture risk associated with parkinsonism (including Parkinson's disease) and drugs used to treat these conditions in a case-control study. Cases were all subjects with any fracture during the year 2000 (n = 124,655). For each case, three controls (n = 373,962) matched on age and gender were randomly drawn from the background population. Exposure was a diagnosis of parkinsonism or use of anticholinergic drugs, levodopa alone or in combination with carbidopa, and/or catechol-O-methyl transferase (COMT) inhibitors, dopamine agonists, or monoamine oxidase B (MAO-B) inhibitors and a number of other confounders. Parkinsonism was associated with a crude odds ratio (OR) of any fracture of 2.2 (95% confidence interval [95% CI] 2.0-2.5) and an adjusted OR of 1.2 (95% CI 1.0-1.4), the risk being higher especially in males younger than 75 years. Levodopa was associated with an increased overall fracture risk and an increased risk of hip fractures in high doses. Dopamine agonists, anticholinergic drugs, and MAO-B inhibitors were not associated with increased fracture risk except for hip fractures at high doses for MAO-B inhibitors and hip fractures at median doses for dopamine agonists. Neuroleptics were associated with increased risk of fractures in almost all skeletal sites and doses. In conclusion, parkinsonism was associated with increased risk of fractures, especially among males younger than 75 years, and the risk was significantly attenuated upon adjustment for confounders. Use of neuroleptics and, to some degree, levodopa was associated with increased risk of fractures. SN - 0171-967X UR - https://www.unboundmedicine.com/medline/citation/17705047/Fracture_risk_associated_with_parkinsonism_and_anti_Parkinson_drugs_ L2 - https://dx.doi.org/10.1007/s00223-007-9065-6 DB - PRIME DP - Unbound Medicine ER -