Background: Although a certain number of studies have reported decreased BMD in subjects with schizophrenia compared to healthy controls, limited studies have been designed and conducted to examine the association between hip fracture and antipsychotic medication use, particularly in subjects with schizophrenia. Objectives: To investigate the association between anti-psychotic treatment and risk of hip fracture in subjects with schizophrenia. Methods: Design: We conducted a nested case-control study to investigate the association between antipsychotic treatment and risk of hip fracture in subjects with schizophrenia. Setting: A total of 605 cases with hip fracture and 2,828 matched controls were identified from 2002 to 2011 using the National Health Insurance Research Database in Taiwan. Main outcome measures: Schizophrenia subjects aged 20 years and older and with newly diagnosed hip fracture. Statistic analysis: We performed conditional logistic regression models (with and without covariates adjustment) to estimate the effect of antipsychotics on risk of hip fracture, according to antipsychotic exposure status, classes, binding affinity, and daily dose, respectively. Results: Current antipsychotic use was associated with an increased risk for hip fracture (adjusted odds ratio (AOR) = 1.69; 95% con fi dence interval (CI): 1.34-2.14). Among current users, new users had a higher risk of hip fracture (AOR = 4.55; 95% CI: 1.96-10.56) than past users (AOR = 1.24; 95% CI: 0.91-1.69). In addition, a significant increased risk of hip fracture was noted in schizophrenia subjects with fi rst-generation antipsychotic use, but not in those with second-generation antipsychotic use. Conclusions: These results extended previous findings and demonstrate an increased risk of hip fracture associated with antipsychotic use in schizophrenia subjects. Further investigation is needed to dissect the underlying mechanisms related to the effect of antipsychotic use on hip fracture in subjects at risk.
Date:
2014-10
Relation:
Pharmacoepidemiology and Drug Safety. 2014 Oct;23(S1):91-92.
