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An updated analysis of opioids increasing the risk of fractures

Author

Listed:
  • Qiaoning Yue
  • Yue Ma
  • Yirong Teng
  • Yun Zhu
  • Hao Liu
  • Shuanglan Xu
  • Jie Liu
  • Jianping Liu
  • Xiguang Zhang
  • Zhaowei Teng

Abstract

Objective: To assess the relationship between opioid therapy for chronic noncancer pain and fracture risk by a meta-analysis of cohort studies and case-control studies. Methods: The included cohort studies and case-control studies were identified by searching the PubMed and EMBASE databases from their inception until May 24, 2019. The outcome of interest was a fracture. This information was independently screened by two authors. When the heterogeneity among studies was significant, a random effects model was used to determine the overall combined risk estimate. Results: In total, 12 cohort studies and 6 case-control studies were included. We used the Newcastle-Ottawa Scale (NOS) to evaluate the quality of the included literature, and 14 of the studies were considered high-quality studies. The overall relative risk of opioid therapy and fractures was 1.78 (95% confidence interval (CI) 1.53–2.07). Subgroup analyses revealed sources of heterogeneity, sensitivity analysis was stable, and no publication bias was observed. Conclusions: The meta-analysis showed that the use of opioids significantly increased the risk of fracture.

Suggested Citation

  • Qiaoning Yue & Yue Ma & Yirong Teng & Yun Zhu & Hao Liu & Shuanglan Xu & Jie Liu & Jianping Liu & Xiguang Zhang & Zhaowei Teng, 2020. "An updated analysis of opioids increasing the risk of fractures," PLOS ONE, Public Library of Science, vol. 15(4), pages 1-12, April.
    • Handle: RePEc:plo:pone00:0220216
    DOI: 10.1371/journal.pone.0220216
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    References listed on IDEAS

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    1. Roger M. Harbord & Ross J. Harris & Jonathan A. C. Sterne, 2009. "Updated tests for small-study effects in meta-analyses," Stata Journal, StataCorp LP, vol. 9(2), pages 197-210, June.
    2. Zhaowei Teng & Yun Zhu & Feihu Wu & Yanhong Zhu & Xiguang Zhang & Chuanlin Zhang & Shuangneng Wang & Lei Zhang, 2015. "Opioids Contribute to Fracture Risk: A Meta-Analysis of 8 Cohort Studies," PLOS ONE, Public Library of Science, vol. 10(6), pages 1-13, June.
    3. Alexander Hirst & Chris Knight & Matt Hirst & Will Dunlop & Ron Akehurst, 2016. "Tramadol and the risk of fracture in an elderly female population: a cost utility assessment with comparison to transdermal buprenorphine," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 17(2), pages 217-227, March.
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