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Bisphosphonates and risk of atrial fibrillation: a meta-analysis.
Arthritis Res Ther. 2010; 12(1):R30.AR

Abstract

INTRODUCTION

Bisphosphonates are the most commonly used drugs for the prevention and treatment of osteoporosis. Although a recent FDA review of the results of clinical trials reported no clear link between bisphosphonates and serious or non-serious atrial fibrillation (AF), some epidemiologic studies have suggested an association between AF and bisphosphonates.

METHODS

We conducted a meta-analysis of non-experimental studies to evaluate the risk of AF associated with bisphosphonates. Studies were identified by searching MEDLINE and EMBASE using a combination of the Medical Subject Headings and keywords. Our search was limited to English language articles. The pooled estimates of odds ratios (OR) as a measure of effect size were calculated using a random effects model.

RESULTS

Seven eligible studies with 266,761 patients were identified: three cohort, three case-control, and one self-controlled case series. Bisphosphonate exposure was not associated with an increased risk of AF [pooled multivariate OR 1.04, 95% confidence interval (CI) 0.92-1.16] after adjusting for known risk factors. Moderate heterogeneity was noted (I-squared score = 62.8%). Stratified analyses by study design, cohort versus case-control studies, yielded similar results. Egger's and Begg's tests did not suggest an evidence of publication bias (P = 0.90, 1.00 respectively). No clear asymmetry was observed in the funnel plot analysis. Few studies compared risk between bisphosphonates or by dosing.

CONCLUSIONS

Our study did not find an association between bisphosphonate exposure and AF. This finding is consistent with the FDA's statement.

Authors+Show Affiliations

Division of Rheumatology, Allergy and Immunology, Department of Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA. skim62@partners.orgNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

20170505

Citation

Kim, Seo Young, et al. "Bisphosphonates and Risk of Atrial Fibrillation: a Meta-analysis." Arthritis Research & Therapy, vol. 12, no. 1, 2010, pp. R30.
Kim SY, Kim MJ, Cadarette SM, et al. Bisphosphonates and risk of atrial fibrillation: a meta-analysis. Arthritis Res Ther. 2010;12(1):R30.
Kim, S. Y., Kim, M. J., Cadarette, S. M., & Solomon, D. H. (2010). Bisphosphonates and risk of atrial fibrillation: a meta-analysis. Arthritis Research & Therapy, 12(1), R30. https://doi.org/10.1186/ar2938
Kim SY, et al. Bisphosphonates and Risk of Atrial Fibrillation: a Meta-analysis. Arthritis Res Ther. 2010;12(1):R30. PubMed PMID: 20170505.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Bisphosphonates and risk of atrial fibrillation: a meta-analysis. AU - Kim,Seo Young, AU - Kim,Min Jung, AU - Cadarette,Suzanne M, AU - Solomon,Daniel H, Y1 - 2010/02/19/ PY - 2009/12/11/received PY - 2010/01/18/revised PY - 2010/02/19/accepted PY - 2010/2/23/entrez PY - 2010/2/23/pubmed PY - 2010/8/14/medline SP - R30 EP - R30 JF - Arthritis research & therapy JO - Arthritis Res Ther VL - 12 IS - 1 N2 - INTRODUCTION: Bisphosphonates are the most commonly used drugs for the prevention and treatment of osteoporosis. Although a recent FDA review of the results of clinical trials reported no clear link between bisphosphonates and serious or non-serious atrial fibrillation (AF), some epidemiologic studies have suggested an association between AF and bisphosphonates. METHODS: We conducted a meta-analysis of non-experimental studies to evaluate the risk of AF associated with bisphosphonates. Studies were identified by searching MEDLINE and EMBASE using a combination of the Medical Subject Headings and keywords. Our search was limited to English language articles. The pooled estimates of odds ratios (OR) as a measure of effect size were calculated using a random effects model. RESULTS: Seven eligible studies with 266,761 patients were identified: three cohort, three case-control, and one self-controlled case series. Bisphosphonate exposure was not associated with an increased risk of AF [pooled multivariate OR 1.04, 95% confidence interval (CI) 0.92-1.16] after adjusting for known risk factors. Moderate heterogeneity was noted (I-squared score = 62.8%). Stratified analyses by study design, cohort versus case-control studies, yielded similar results. Egger's and Begg's tests did not suggest an evidence of publication bias (P = 0.90, 1.00 respectively). No clear asymmetry was observed in the funnel plot analysis. Few studies compared risk between bisphosphonates or by dosing. CONCLUSIONS: Our study did not find an association between bisphosphonate exposure and AF. This finding is consistent with the FDA's statement. SN - 1478-6362 UR - https://www.unboundmedicine.com/medline/citation/20170505/Bisphosphonates_and_risk_of_atrial_fibrillation:_a_meta_analysis_ L2 - https://arthritis-research.biomedcentral.com/articles/10.1186/ar2938 DB - PRIME DP - Unbound Medicine ER -