Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Sep 1;21(3):422-428.

Anticonvulsant use and fracture: a case-control study

Vinoomika Chandrasekaran  1 , Amanda L Stuart  1 , Julie A Pasco  1   2   3   4 , Sharon L Brennan-Olsen  3   5   6   7 , Michael Berk  1   2   4   8   9   10 , Jason M Hodge  1   10   11 , Rasika M Samarasinghe  1 , Lana J Williams  1
Affiliations

Anticonvulsant use and fracture: a case-control study

Vinoomika Chandrasekaran et al. J Musculoskelet Neuronal Interact. .

Abstract

Objectives: We aimed to investigate fracture risk associated with anticonvulsant use in a population-based sample of men and women.

Methods: Data from 1,458 participants (51.8% women) with a radiologically confirmed incident fracture (cases) were compared to 1,796 participants (46.5% women) without fracture (controls). Lifestyle factors, medication use and medical history were self-reported. Associations between anticonvulsant use and fracture were explored using binary logistic regression following adjustment for confounders.

Results: In men, fracture cases and controls differed in age, smoking history, education, alcohol use, and gonadal hormone supplementation. In women, fracture cases and controls differed by previous fracture history, alcohol use, physical activity levels and use of anti-fracture agents. After adjustment for age, pooled anticonvulsant use was associated with a 3.4-fold higher risk of fracture in men and a 1.8-fold higher risk in women. Following further adjustments for confounders these patterns persisted; a 2.8-fold higher fracture risk in men and a 1.8-fold higher fracture risk in women.

Conclusions: Anticonvulsant use was associated with increased fracture risk, independent of demographic, lifestyle, medical and medication related factors. While further studies exploring potential underlying mechanisms are warranted, regular monitoring of bone health in anticonvulsant users with risk factors may be useful.

Keywords: Anticonvulsant; Case-Control Study; Fracture; Osteoporosis.

PubMed Disclaimer

Conflict of interest statement

None of the authors has any relevant conflict of interest related to this study. JAP has received speaker fees from Amgen, Eli Lilly and Sanofi-Aventis and funding from the Geelong Region Medical Research Foundation, Barwon Health, Perpetual Trustees, The University of Melbourne, Deakin University, ANZ Charitable Trust, the American Society for Bone and Mineral Research, Amgen (Europe) GmBH, Amgen-GSK OA-ANZBMS, the BUPA Foundation, Western Alliance, the City of Greater Geelong, the Beischer Foundation, Osteoporosis Australia, Australia and New Zealand Bone and Mineral Society and the NHMRC. SLB-O has received Honorarium fees from Amgen Australia and Pfizer Australia, and Grant/Research support from the University of Melbourne, Deakin University, Arthritis Victoria, Arthritis Australia, Australian Association of Gerontology, City of Greater Geelong, and Sanofi Australia. MB has received Grant/Research Support from the NIH, Cooperative Research Centre, Simons Autism Foundation, Cancer Council of Victoria, Stanley Medical Research Foundation, Medical Benefits Fund, National Health and Medical Research Council, Medical Research Futures Fund, Beyond Blue, Rotary Health, A2 milk company, Meat and Livestock Board, Woolworths, Avant and the Harry Windsor Foundation, has been a speaker for Astra Zeneca, Lundbeck, Merck, Pfizer, and served as a consultant to Allergan, Astra Zeneca, Bioadvantex, Bionomics, Collaborative Medicinal Development, Lundbeck Merck, Pfizer and Servier – all unrelated to this work. LJW has received Grant/Research support from Eli Lilly, Pfizer, The University of Melbourne, Deakin University and the NHMRC. VC, ALS, JH and RS have no conflict of interest.

References

    1. Knezevic CE, Marzinke MA. Clinical Use and Monitoring of Antiepileptic Drugs. J Appl Lab Med. 2020;3(1):115–127. - PubMed
    1. Vossler DG, Weingarten M, Gidal BE. American Epilepsy Society Treatments C. Summary of Antiepileptic Drugs Available in the United States of America:Working Toward A World Without Epilepsy. Epilepsy Curr. 2018;18(4 Suppl 1):1–26. - PMC - PubMed
    1. Meldrum BS, Rogawski MA. Molecular targets for antiepileptic drug development. Neurotherapeutics. 2007;4(1):18–61. - PMC - PubMed
    1. Chen H, Deshpande AD, Jiang R, Martin BC. An epidemiological investigation of off-label anticonvulsant drug use in the Georgia Medicaid population. Pharmacoepidemiol Drug Saf. 2005;14(9):629–638. - PubMed
    1. Radley DC, Finkelstein SN, Stafford RS. Off-label Prescribing Among Office-Based Physicians. Arch Intern Med. 2006;166(9):1021–1026. - PubMed

Publication types

Substances