PLoS ONE (Jan 2020)

An updated analysis of opioids increasing the risk of fractures.

  • Qiaoning Yue,
  • Yue Ma,
  • Yirong Teng,
  • Yun Zhu,
  • Hao Liu,
  • Shuanglan Xu,
  • Jie Liu,
  • Jianping Liu,
  • Xiguang Zhang,
  • Zhaowei Teng

DOI
https://doi.org/10.1371/journal.pone.0220216
Journal volume & issue
Vol. 15, no. 4
p. e0220216

Abstract

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OBJECTIVE:To assess the relationship between opioid therapy for chronic noncancer pain and fracture risk by a meta-analysis of cohort studies and case-control studies. METHODS:The included cohort studies and case-control studies were identified by searching the PubMed and EMBASE databases from their inception until May 24, 2019. The outcome of interest was a fracture. This information was independently screened by two authors. When the heterogeneity among studies was significant, a random effects model was used to determine the overall combined risk estimate. RESULTS:In total, 12 cohort studies and 6 case-control studies were included. We used the Newcastle-Ottawa Scale (NOS) to evaluate the quality of the included literature, and 14 of the studies were considered high-quality studies. The overall relative risk of opioid therapy and fractures was 1.78 (95% confidence interval (CI) 1.53-2.07). Subgroup analyses revealed sources of heterogeneity, sensitivity analysis was stable, and no publication bias was observed. CONCLUSIONS:The meta-analysis showed that the use of opioids significantly increased the risk of fracture.