Complain about a product or service

Common Blood Thinner Increases Risk of Bone Fracture

January 30, 2006

Osteoporosis • Aspirin May Prevent Osteoporosis • Researchers Accuse Pharmas of 'Disease Mongering' • Calcium Supplements May Increase Older Women's Heart Risk • Dietary Calcium Protects Bones Better than Supplements • Older Adults Vulnerable to Refractures • Women May Be Able to Take a Break From Osteoporosis Drug • Second-Hand Smoke Hikes Osteoporosis Risk • Study: Young Women Don't Get Enough Calcium • Common Blood Thinner Increases Risk of Bone Fracture • Magnesium May Prevent Osteoporosis • Risk Factors for Osteoporosis

Elderly patients taking the commonly prescribed blood thinner warfarin experience an increased risk for osteoporosis-linked bone fractures, according to a study at Washington University School of Medicine in St. Louis.

The results suggest physicians should carefully monitor the bone health of patients placed on the medication and that their patients should take steps to decrease the risk of osteoporosis.

Warfarin, also known by the brand-name Coumadin, is often given to patients with atrial fibrillation, irregular contractions of the upper chambers of the heart. By interfering with vitamin K's role in clotting, the drug decreases formation of blood clots, which often accompany atrial fibrillation.

But because vitamin K also interacts with osteocalcin—a protein vital for bone formation—warfarin's antagonism of vitamin K has the potential to affect bone strength as well. Osteoporotic fractures occur when the bones become so weakened that minor trauma causes breakage.

"We did a retrospective study of Medicare records for about 15,000 patients hospitalized with atrial fibrillation, and we identified fractures related to osteoporosis," says lead author Brian Gage, M.D., associate professor of medicine and medical director of Barnes-Jewish Hospital's Blood Thinner Clinic.

"Our analysis showed that long-term use of warfarin—longer than one year— led to a 25 percent increase in the incidence of fracture."

The study included about an equal number of men and women with an average age of 80. In the general population, 80 percent of those affected by osteoporosis are women, and women in this study were more likely to have an osteoporotic fracture than were men.

But the women's risk of fracture did not increase by a statistically meaningful amount on long-term warfarin therapy. However, men in the study who took warfarin for more than a year had a 63 percent higher incidence of fracture than men who did not take the blood thinner.

Patients taking warfarin for less than one year did not have increased fracture risk, and patients taking beta-blockers had fewer fractures than patients not taking beta-blockers.

More than half of the fractures seen in the study group were hip fractures. The rest involved the spine and wrist. Osteoporotic fractures often result in lost mobility and death in many cases. In the study group, 39 percent of patients with hip fractures died within 30 days, with substantial mortality evidenced for other types of osteoporotic fractures as well.

"The results of the study have important implications for treatment of atrial fibrillation," Gage says. "To maintain bone strength, elderly patients taking warfarin should exercise regularly and have adequate intakes of calcium and vitamin D. Those who are prone to falling could use walking aids and proper footwear. Smokers should quit, which will decrease their risk of osteoporosis and other diseases."

The study adds to evidence suggesting that vitamin K is important for bone health. Gage says he hopes that anticoagulants that do not inhibit vitamin K will be developed.

Report Your Experience
If you've had a bad experience -- or a good one -- with a consumer product or service, we'd like to hear about it. All complaints are reviewed by class action attorneys and are considered for publication on our site. Knowledge is power! Help spread the word. File your consumer report now.