26 Nov Effect of Anticoagulants Warfarin vs DOACs on Bone Health
MedicalResearch.com Interview with:
Dr. Lutsey
Pamela L. Lutsey, PhD
Associate Professor
Division of Epidemiology and Community Health
University of Minnesota School of Public Health
Minneapolis
MedicalResearch.com: What is the background for this study?
Response: Warfarin is prescribed to atrial fibrillation (AF) patients for the prevention of cardioembolic complications. However, whether it adversely impacts bone health is controversial.
With the availability of alternate direct oral anticoagulant (DOAC) options, it is now possible to evaluate the comparative safety of warfarin in relation to fracture risk.
MedicalResearch.com: What should readers take away from your report?
Response: We found that use of DOACs, particularly apixaban, compared to warfarin use – was associated with lower fracture risk.
These associations were more pronounced among patients with a diagnosis of osteoporosis.
This study adds to the growing body of evidence suggesting that warfarin has an adverse effect on bone health. Caution should be used when prescribing warfarin to AF patients at elevated fracture risk.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: The finding that the association was stronger among those with clinical evidence of osteoporosis was unexpected, and warrants further exploration.
I have nothing to disclose.
Citation:
Lutsey PL, Norby FL, Ensrud KE, et al. Association of Anticoagulant Therapy With Risk of Fracture Among Patients With Atrial Fibrillation. JAMA Intern Med. Published online November 25, 2019. doi: https://doi.org/10.1001/jamainternmed.2019.5679
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Last Updated on November 26, 2019 by Marie Benz MD FAAD