Saving bones without risking brain—bisphosphonates and risk of stroke: matched case-control study

We investigated the association between bisphosphonate treatment and the risk of stroke using a large routine clinical dataset. We found no association between bisphosphonate treatment and risk of stroke, after adjusting for large number of clinical and demographic confounders. INTRODUCTION:There is...

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Main Authors: Asghar, Z, Godoy Caballero, A, Pathirannehelage, S, Williams, J, McKay, S, Grassby, P, de Lusignan, S, Niroshan Siriwardena, A
Format: Journal article
Language:English
Published: Springer 2019
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author Asghar, Z
Godoy Caballero, A
Pathirannehelage, S
Williams, J
McKay, S
Grassby, P
de Lusignan, S
Niroshan Siriwardena, A
author_facet Asghar, Z
Godoy Caballero, A
Pathirannehelage, S
Williams, J
McKay, S
Grassby, P
de Lusignan, S
Niroshan Siriwardena, A
author_sort Asghar, Z
collection OXFORD
description We investigated the association between bisphosphonate treatment and the risk of stroke using a large routine clinical dataset. We found no association between bisphosphonate treatment and risk of stroke, after adjusting for large number of clinical and demographic confounders. INTRODUCTION:There is conflicting evidence on the link between bisphosphonates and stroke with studies variously showing increased, decreased or unchanged risk. We investigated the association between bisphosphonate treatment and the risk of stroke using a large routine clinical dataset. METHODS:We used a matched nested case-control study design analysing routinely collected electronic data from patients registered at primary care practices in England participating in the Royal College of General Practitioners Research and Surveillance Centre. Cases were patients aged 18 years or over, either living or dead, recorded as having had a stroke in the period 1 January 2005 to 31 March 2016. Each case was matched to one control according to age, sex, general practice attended and calendar time. Data were analysed using Stata, version 14.2. and RStudio, version 1.1.463. Conditional logistic regression was used to determine odds ratios for stroke according to bisphosphonate treatment and duration in cases compared with controls. We adjusted for disease risk groups, cardiovascular risk factors, treatments, smoking status, alcohol consumption, ethnicity, bisphosphonate types, fracture and socioeconomic status using IMD (Index of Multiple Deprivation). RESULTS:We included 31,414 cases of stroke with an equal number of matched controls. Overall, 83.2% of cases and controls were aged 65 years or older, and there were similar proportions of females (51.5%) and males (48.5%). Bisphosphonate treatment was not associated with stroke after adjusting for the wide range of confounders considered (OR 0.86, 95% CI 0.62-1.19). CONCLUSIONS:We found no association between bisphosphonate treatment and risk of stroke, after adjusting for other confounders.
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spelling oxford-uuid:cdeb270e-0e04-4ab3-85b0-2570f2534d4b2022-03-27T07:32:05ZSaving bones without risking brain—bisphosphonates and risk of stroke: matched case-control studyJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:cdeb270e-0e04-4ab3-85b0-2570f2534d4bEnglishSymplectic Elements at OxfordSpringer2019Asghar, ZGodoy Caballero, APathirannehelage, SWilliams, JMcKay, SGrassby, Pde Lusignan, SNiroshan Siriwardena, AWe investigated the association between bisphosphonate treatment and the risk of stroke using a large routine clinical dataset. We found no association between bisphosphonate treatment and risk of stroke, after adjusting for large number of clinical and demographic confounders. INTRODUCTION:There is conflicting evidence on the link between bisphosphonates and stroke with studies variously showing increased, decreased or unchanged risk. We investigated the association between bisphosphonate treatment and the risk of stroke using a large routine clinical dataset. METHODS:We used a matched nested case-control study design analysing routinely collected electronic data from patients registered at primary care practices in England participating in the Royal College of General Practitioners Research and Surveillance Centre. Cases were patients aged 18 years or over, either living or dead, recorded as having had a stroke in the period 1 January 2005 to 31 March 2016. Each case was matched to one control according to age, sex, general practice attended and calendar time. Data were analysed using Stata, version 14.2. and RStudio, version 1.1.463. Conditional logistic regression was used to determine odds ratios for stroke according to bisphosphonate treatment and duration in cases compared with controls. We adjusted for disease risk groups, cardiovascular risk factors, treatments, smoking status, alcohol consumption, ethnicity, bisphosphonate types, fracture and socioeconomic status using IMD (Index of Multiple Deprivation). RESULTS:We included 31,414 cases of stroke with an equal number of matched controls. Overall, 83.2% of cases and controls were aged 65 years or older, and there were similar proportions of females (51.5%) and males (48.5%). Bisphosphonate treatment was not associated with stroke after adjusting for the wide range of confounders considered (OR 0.86, 95% CI 0.62-1.19). CONCLUSIONS:We found no association between bisphosphonate treatment and risk of stroke, after adjusting for other confounders.
spellingShingle Asghar, Z
Godoy Caballero, A
Pathirannehelage, S
Williams, J
McKay, S
Grassby, P
de Lusignan, S
Niroshan Siriwardena, A
Saving bones without risking brain—bisphosphonates and risk of stroke: matched case-control study
title Saving bones without risking brain—bisphosphonates and risk of stroke: matched case-control study
title_full Saving bones without risking brain—bisphosphonates and risk of stroke: matched case-control study
title_fullStr Saving bones without risking brain—bisphosphonates and risk of stroke: matched case-control study
title_full_unstemmed Saving bones without risking brain—bisphosphonates and risk of stroke: matched case-control study
title_short Saving bones without risking brain—bisphosphonates and risk of stroke: matched case-control study
title_sort saving bones without risking brain bisphosphonates and risk of stroke matched case control study
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