Dagibatran carries reduced fracture risk compared with warfarin

Among patients with nonvalvular atrial fibrillation, study data show the use of dabigatran rather than warfarin was associated with a lower risk of osteoporotic fracture.

Xray of a femur with a fracture from osteoporosis

Warfarin has been associated with increased risk of osteoporotic fractures but it has been suggested that dabigatran, which has a different mode of action, might not carry the same risk.

To explore, researchers studied data from a Hong Kong hospital taken from patients with nonvalvular atrial fibrillation, including 3,268 new dabigatran users which were matched to 4,884 new warfarin users.

During a mean follow-up of 501 days, the risk of osteoporotic fracture was significantly lower among dabigatran users than warfarin users (0.7 vs 1.1 per 100 person-years). However, the association with lower risk was only statistically significant for patients with a history of fractures and/or falls (1.6 vs 3.6 per 100 person-years) but not for those without (0.6 vs 0.7 per 100 person years).

Reporting in JAMA
(online, 21 March 2017), the researchers suggest that patients could be screened for osteoporotic risk to inform anticoagulant choice, but the findings warrant further investigation.


[1] Lau WC, Chan EW, Cheung C-L et al. Association between dabigatran vs warfarin and risk of osteoporotic fractures among patients with nonvalvular atrial fibrillation. JAMA 2017;317:1151-1158. doi: 10.1001/jama.2017.1363

Last updated
Clinical Pharmacist, CP, May 2017, Vol 9, No 5;9(5):DOI:10.1211/PJ.2017.20202567

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