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
Abstract
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.