Withdrawn 33rd ASM of the Australian & New Zealand Bone & Mineral Society 2023

Antipsychotic medication use and fracture: a case-control study (#35)

Behnaz Azimi Manavi 1 , Amanda L Stuart 1 , Julie A Pasco 1 2 3 4 , Jason M Hodge 1 2 , Kavindi Weerasinghe 1 , Rasika M Samarasinghe 1 , Lana J Williams 1 2
  1. School of Medicine, Deakin University, Geelong, VIC, Australia
  2. Barwon Health, Geelong, VIC, Australia
  3. Department of Medicine-Western Health, The University of Melbourne, St Albans, VIC, Australia
  4. Department of Epidemiology and Preventive Medicine, Monash University, , melbourne, vic, australia

Background: It has been reported that antipsychotic use is associated with lower bone mineral density and bone quality. We aimed to determine whether antipsychotic use is associated with fracture risk in a population-based sample of adults living in the Barwon Statistical Division, south-eastern Australia.

 

Methods: In this case-control study, 1,458 participants (51.8% women) with radiologically confirmed fracture between June 1st 2012 and May 31st 2013 (cases) were compared with 1,795 participants (46.5% women) without fracture (controls) for the same time period. Medication use, medical history and lifestyle factors were documented by self-report. Multivariable binary logistic regression was used to explore associations between antipsychotic use and fracture following adjustment for possible confounders.

 

Results: In women, antipsychotic use was identified for 20 of 755 (2.6%) cases and 10 of 834 (1.2%) controls (p=0.034) and in men, antipsychotic use was identified for 13 of 703 (1.8%) cases and 5 of 961 (0.5%) controls (p=0.010). Following adjustments, antipsychotic use was associated with a 3.0-fold increased risk of fracture in men and a 2.3-fold increased risk of fracture in women. Patterns persisted after exclusion of participants with minor fractures and self-reported schizophrenia.

 

Conclusion: Our results demonstrate that exposure to antipsychotic medication is associated with increased fracture risk in both men and women. Assessment of bone health among antipsychotic users should be considered, with early detection and management of bone loss likely to reduce fracture risk. Future research investigating the underlying mechanism in the association between antipsychotic use and fracture is warranted.