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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.

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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, JulieORCID iD for 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
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