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Journal Article

Citation

Carrier H, Cortaredona S, Philipps V, Jacqmin-Gadda H, Tournier M, Verdoux H, Verger P. Br. J. Clin. Pharmacol. 2020; ePub(ePub): ePub.

Affiliation

ORS Paca, Regional Health Observatory, Provence-Alpes-Côte d'Azur, F-13006, Marseille, France.

Copyright

(Copyright © 2020, John Wiley and Sons)

DOI

10.1111/bcp.14307

PMID

32285959

Abstract

AIMS: This article sought to study the association between patterns of benzodiazepine (BZD) use and the risk of hip and forearm fractures in people aged 50 and 75 years or more.

METHODS: In a representative cohort of the French National Health Insurance Fund of individuals aged 50 years or older) (N=106 437), we followed up BZD dispensing (reflecting their patterns of use) and the most frequent fall-related fractures (hip and forearm) for 8 years. We used joint latent class models to simultaneously identify BZD dispensing trajectories and the risk of fractures in the entire cohort and in those 75 years or older). We used a survival model to estimate the adjusted hazard ratios (aHRs) between these trajectories and the risk of fractures.

RESULTS: In the entire cohort, we identified 5 BZD trajectories: "non-users" (76.7% of the cohort); "occasional users" (15.2%); "decreasing users"(2.6%); "late increasing users" (3.0%); and "early increasing users" (2.4%). Compared with non-users, fracture risk was not increased in either occasional users (aHR = 0.99, 95% CI 0.99-1.00) or in decreasing users (aHR = 0.90, 95% CI 0.74-1.08). It was significantly higher in early increasing users (aHR = 1.86, 95% CI 1.62-2.14) and in late increasing users (aHR = 1.39, 95% CI 1.15-1.60). We observed similar trajectories and risk levels in the people older than 75 years.

CONCLUSION: Occasional BZD use, which is compatible with current recommendations, was not associated with an excess risk of the most frequent fall-related fractures in people older than 50 or 75 years.

This article is protected by copyright. All rights reserved.


Language: en

Keywords

Adverse Drug Reactions; Benzodiazepines; Drug utilization; Pharmacoepidemiology

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