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Title: Aspirin and fracture risk: a systematic review and exploratory meta-analysis of observational studies.
Austin Authors: Barker, A L;Soh, Sze-Ee;Sanders, Kerrie M;Pasco, Julie;Khosla, Sundeep;Ebeling, Peter R;Ward, Stephanie A;Peeters, Geeske;Talevski, Jason;Cumming, Robert G;Seeman, Ego ;McNeil, John J
Affiliation: Division of Endocrinology and Center on Aging, Rochester, Minnesota, USA
Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
Mary McKillip Institute of Healthy Aging, Australian Catholic University, Melbourne, Victoria, Australia
Member Health, Medibank Private, Melbourne, Victoria, Australia
Department of Physiotherapy, Monash University, Melbourne, Victoria, Australia
Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
School of Public Health, University of Sydney, Camperdown, New South Wales, Australia
Bone and Muscle Health Research Group, School of Clinical Sciences at Monash Health, Monash Medical Centre, Melbourne, Victoria, Australia
Clinical and Biomedical Sciences: Barwon Health, The University of Melbourne, Geelong, Victoria, Australia
Department of Medicine-Western Health, University of Melbourne Faculty of VCA and MCM, Melbourne, Victoria, Australia
Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, Melbourne, Victoria, Australia
Department of Endocrinology, Austin Health, Heidelberg, Victoria, Australia
Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland..
Issue Date: 20-Feb-2020 2020-02-20
Publication information: BMJ Open 2020; 10(2): e026876
Abstract: This review provides insights into the potential for aspirin to preserve bone mineral density (BMD) and reduce fracture risk, building knowledge of the risk-benefit profile of aspirin. We conducted a systematic review and exploratory meta-analysis of observational studies. Electronic searches of MEDLINE and Embase, and a manual search of bibliographies was undertaken for studies published to 28 March 2018. Studies were included if: participants were men or women aged ≥18 years; the exposure of interest was aspirin; and relative risks, ORs and 95% CIs for the risk of fracture or difference (percentage or absolute) in BMD (measured by dual energy X-ray absorptiometry) between aspirin users and non-users were presented. Risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklists for observational studies. Pooled ORs for any fracture and standardised mean differences (SMDs) for BMD outcomes were calculated using random-effects models. Twelve studies met the inclusion criteria and were included in the meta-analysis. Aspirin use was associated with a 17% lower odds for any fracture (OR 0.83, 95% CI 0.70 to 0.99; I2=71%; six studies; n=511 390). Aspirin was associated with a higher total hip BMD for women (SMD 0.03, 95% CI -0.02 to 0.07; I2=0%; three studies; n=9686) and men (SMD 0.06, 95% CI -0.02 to 0.13, I2=0%; two studies; n=4137) although these associations were not significant. Similar results were observed for lumbar spine BMD in women (SMD 0.03, 95% CI -0.03 to 0.09; I2=34%; four studies; n=11 330) and men (SMD 0.08; 95% CI -0.01 to 0.18; one study; n=432). While the benefits of reduced fracture risk and higher BMD from aspirin use may be modest for individuals, if confirmed in prospective controlled trials, they may confer a large population benefit given the common use of aspirin in older people.
DOI: 10.1136/bmjopen-2018-026876
ORCID: 0000-0002-9692-048X
PubMed URL: 32086348
Type: Journal Article
Subjects: ageing
fracture prevention
general population studies
therapeutics (other)
Appears in Collections:Journal articles

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