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Br J Clin Pharmacol. 2015 Nov;80(5):1208-18. doi: 10.1111/bcp.12671. Epub 2015 Sep 22.

Risk of hip/femur fractures during the initiation period of α-adrenoceptor blocker therapy among elderly males: a self-controlled case series study.

Lai CL1,2,3, Kuo RN4,5, Chen HM5, Chen MF6, Chan KA7,8, Lai MS3,5.

Author information

1
Department of Internal Medicine and Center for Critical Care Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu.
2
Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei.
3
Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei.
4
Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei.
5
Center for Comparative Effectiveness Research, National Center of Excellence for Clinical Trial and Research, National Taiwan University Hospital, Taipei.
6
Department of Internal Medicine, National Taiwan University Hospital, Taipei.
7
Department of Medical Research, National Taiwan University Hospital, Taipei.
8
Graduate Institute of Oncology, College of Medicine, National Taiwan University, Taipei, Taiwan.

Abstract

AIMS:

This study aimed to evaluate the risk of hip/femur fractures during the initiation period of α-adrenoceptor blocker therapy using the National Health Insurance claims database, Taiwan, with a self-controlled case series design.

METHODS:

All male beneficiaries aged over 50 years as of 2007, who were incident users of α-adrenoceptor blockers and also had a diagnosis of hip/femur fracture within the 2007-2009 study period were identified. The first day when the α-adrenoceptor blocker was prescribed was set as the index date. We partitioned the initial 21 day period following the index date as the post-exposure risk period 1, days 22-60 after the index date as the post-exposure risk period 2, the 21 day period prior to the index date as the pre-exposure risk period 1 and days 22-60 prior to the index date as the pre-exposure risk period 2. The remainder of the study period was defined as the unexposed period. The incidence rate ratio (IRR) of hip/femur fractures within each risk period compared with the unexposed period was estimated using a conditional Poisson regression model.

RESULTS:

A total of 5875 men were included. Compared with the unexposed period, the IRR of hip/femur fractures was 1.36 (95% confidence interval 1.06, 1.74, P = 0.017) within the post-exposure risk period 1 for patients without concomitant prescriptions of anti-hypertensive agents.

CONCLUSIONS:

Use of α-adrenoceptor blockers was associated with a small but significant increase in the risk of hip/femur fractures during the early initiation period in patients without concomitant prescriptions of anti-hypertensive agents.

KEYWORDS:

adrenergic α1-receptor antagonists; femoral fractures; hip fractures; self-controlled case series design

PMID:
25924025
PMCID:
PMC4631193
DOI:
10.1111/bcp.12671
[Indexed for MEDLINE]
Free PMC Article

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