Aspirin and fracture risk: A systematic review and exploratory meta-analysis of observational studies 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 and McNeil, John J. 2020, Aspirin and fracture risk: A systematic review and exploratory meta-analysis of observational studies, BMJ Open, vol. 10, no. 2, doi: 10.1136/bmjopen-2018-026876. Attached Files Name Description MIMEType Size Downloads Title Aspirin and fracture risk: A systematic review and exploratory meta-analysis of observational studies Author(s) Barker, A. L. Soh, Sze-Ee Sanders, Kerrie M. Pasco, Julie orcid.org/0000-0002-8968-4714 Khosla, Sundeep Ebeling, Peter R. Ward, Stephanie A. Peeters, Geeske Talevski, Jason Cumming, Robert G. Seeman, Ego McNeil, John J. Journal name BMJ Open Volume number 10 Issue number 2 Article ID e026876 Total pages 12 Publisher B M J Group Place of publication London, Eng. Publication date 2020-02-20 ISSN 2044-6055 2044-6055 Keyword(s) ageing fracture prevention general population studies osteoporosis therapeutics (other) Summary ObjectivesThis 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.MethodsWe 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.ResultsTwelve 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).ConclusionsWhile 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. Language eng DOI 10.1136/bmjopen-2018-026876 Indigenous content off Field of Research 1103 Clinical Sciences 1117 Public Health and Health Services 1199 Other Medical and Health Sciences HERDC Research category C1 Refereed article in a scholarly journal Copyright notice ©2020, The Authors Free to Read? Yes Persistent URL http://hdl.handle.net/10536/DRO/DU:30136829 Document type: Journal Article Collections: Faculty of Health School of Medicine Open Access Collection Related Links Link Description Link to full-text (open access)     Unless expressly stated otherwise, the copyright for items in DRO is owned by the author, with all rights reserved. Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au. Versions Version Filter Type Mon, 11 May 2020, 13:41:02 EST Tue, 12 May 2020, 05:05:00 EST Tue, 12 May 2020, 08:10:54 EST Mon, 14 Dec 2020, 05:02:17 EST Wed, 16 Dec 2020, 12:15:08 EST Wed, 16 Dec 2020, 12:21:11 EST Wed, 16 Dec 2020, 15:03:03 EST Filtered Full Citation counts:   Cited 0 times in TR Web of Science Cited 4 times in Scopus Search Google Scholar Access Statistics: 35 Abstract Views, 0 File Downloads  -  Detailed Statistics Created: Mon, 11 May 2020, 13:41:02 EST

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