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Review
. 2019 Oct 24;20(21):5275.
doi: 10.3390/ijms20215275.

Anticoagulants and Osteoporosis

Salvatore Santo Signorelli  1 , Salvatore Scuto  2 , Elisa Marino  3 , Michele Giusti  4 , Anastasia Xourafa  5 , Agostino Gaudio  6
Affiliations
Review

Anticoagulants and Osteoporosis

Salvatore Santo Signorelli et al. Int J Mol Sci. .

Abstract

Anticoagulant agents are widely used in the treatment of thromboembolic events and in stroke prevention. Data about their effects on bone tissue are in some cases limited or inconsistent (oral anti-vitamin K agents), and in others are sufficiently strong (heparins) to suggest caution in their use in subjects at risk of osteoporosis. This review analyses the effects of this group of drugs on bone metabolism, on bone mineral density, and on fragility fractures. A literature search strategy was developed by an experienced team of specialists by consulting the MEDLINE platform, including published papers and reviews updated to March 2019. Literature supports a detrimental effect of heparin on bone, with an increase in fracture rate. Low molecular weight heparins (LMWHs) seem to be safer than heparin. Although anti-vitamin K agents (VKAs) have a significant impact on bone metabolism, and in particular, on osteocalcin, data on bone mineral density (BMD) and fractures are contrasting. To date, the new direct oral anticoagulants (DOACs) are found to safe for bone health.

Keywords: anticoagulant agents; fracture; heparin; low molecular weight heparins (LMWHs); osteoporosis; warfarin.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Anticoagulants’ safety on bone. LMWHs (Low molecular weight heparins), VKAs (Vitamin K antagonists), DOACs (Direct-acting oral anticoagulants).
See this image and copyright information in PMC

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