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Arthritis Res Ther. 2010;12(1):R30. doi: 10.1186/ar2938. Epub 2010 Feb 19.

Bisphosphonates and risk of atrial fibrillation: a meta-analysis.

Author information

  • 1Division of Rheumatology, Allergy and Immunology, Department of Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA. skim62@partners.org

Abstract

INTRODUCTION:

Bisphosphonates are the most commonly used drugs for the prevention and treatment of osteoporosis. Although a recent FDA review of the results of clinical trials reported no clear link between bisphosphonates and serious or non-serious atrial fibrillation (AF), some epidemiologic studies have suggested an association between AF and bisphosphonates.

METHODS:

We conducted a meta-analysis of non-experimental studies to evaluate the risk of AF associated with bisphosphonates. Studies were identified by searching MEDLINE and EMBASE using a combination of the Medical Subject Headings and keywords. Our search was limited to English language articles. The pooled estimates of odds ratios (OR) as a measure of effect size were calculated using a random effects model.

RESULTS:

Seven eligible studies with 266,761 patients were identified: three cohort, three case-control, and one self-controlled case series. Bisphosphonate exposure was not associated with an increased risk of AF [pooled multivariate OR 1.04, 95% confidence interval (CI) 0.92-1.16] after adjusting for known risk factors. Moderate heterogeneity was noted (I-squared score = 62.8%). Stratified analyses by study design, cohort versus case-control studies, yielded similar results. Egger's and Begg's tests did not suggest an evidence of publication bias (P = 0.90, 1.00 respectively). No clear asymmetry was observed in the funnel plot analysis. Few studies compared risk between bisphosphonates or by dosing.

CONCLUSIONS:

Our study did not find an association between bisphosphonate exposure and AF. This finding is consistent with the FDA's statement.

PMID:
20170505
[PubMed - indexed for MEDLINE]
PMCID:
PMC2875664
Free PMC Article

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