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
[1]
(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.

References

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