Meta-Analysis of Epidemiologic Studies on Tricyclic Antidepressants and Fracture Risk

• Activity Number: 526
• Type: Contributed
• Date/Time: Wednesday, August 1, 2012 : 10:30 AM to 12:20 PM
• Sponsor: Section on Statistics in Epidemiology
• Author(s): Qing Wu*+ and Wenchun Qu and Michael D Crowell and Joseph G Hentz and Keith A Frey
• Companies: Mayo Clinic and Mayo Clinic and Mayo Clinic and Mayo Clinic and Mayo Clinic

Abstract

Studies on use of tricyclic antidepressants (TCAs) and risk of fracture have yielded inconsistent results. We conducted a meta-analysis of observational studies to assess whether people who take TCAs are at an increased risk of fracture. Relevant studies published through December 2010 were identified through literature searches using MEDLINE, EMBASE, SCOPUS, and manual searching of reference lists. Only cohort or case-control studies that examined the association of TCAs and risk of fracture were included. Data were abstracted independently by two investigators using a standardized protocol; disagreements were resolved by consensus. Cochran Q statistics were used to assess heterogeneity among included studies. To estimate the overall effect size, each study was weighted by the reciprocal of its variance. Random effects models were used for pooled analysis due to heterogeneity. Twelve studies met inclusion criteria. Overall, TCA use was associated with a significantly increased risk of fracture (RR, 1.44; 95% CI [1.31, 1.60]; p<0.001). The estimate was consistent in sensitivity analysis. This meta-analysis demonstrated that TCAs treatment is associated with increased risk of fracture.