Associations between Drugs and Fractures

From Ganfyd

Jump to: navigation, search

Much of the data presented below on associations between fractures and drugs is from case control studies. While many will be familiar twith the association between steroids and fractures, other drugs actually have higher relative risk. The data should be interpreted in the context that much evidence is from a few large patient data bases and so random associations are possible. Even more important, the control for known and unknown independent variables predicting fracture may have been incomplete. The independent variables associated with hip fracture in postmenopausal women without self reported chronic disease include:

  • Previous fragility fracture OR=3.33 (CI 1.75-5.66)
  • Hip bone mineral density (BMD) OR=3.15 (CI 1.75-5.66)
  • Little physical activity OR=2.08 (CI 1.17-3.69)
  • Grip strength OR= 2.05 (CI 1.15-3.64)
  • Age OR=1.90 (95% CI 1.04-3.46)
  • Maternal history of fracture OR=1.77 (CI 1.01-3.09)
  • Past falls OR=1.76 (CI 1.00-3.09)

The following variables are probably not independent but have been claimed to be[1]:

  • Weight
  • Weight loss
  • Height loss
  • Smoking (see below)
  • Neuromuscular coordination

When real patients with chronic disease are studied drugs become more important and both they and certain diseases like depression are strong predictors of fractures.[2]


Risk associated with various drugs or drug classes (AOR=adjusted odds ratio, HR= Multivariate hazard ratio)
Drug Relative Risk Comments Evidence Strength
Corticosteroids ↑ with more than 500mg in 5 years OR=1.36 (CI=1.19-1.56)[3]
↑ more than 1500mg in 5 years OR=1.65 (95% CI=1.43-1.92) [4] 		Is likely to be ineffective or harmful with moderate quality evidence level 3b
PPIs ↑ hip fracture with more than 1 year of therapy AOR=1.44 (95% CI 1.30-1.59; P<.001).[5]OR=1.45 (95% CI 1.28-1.65)[6]
↑ all fractures OR = 1.18 (95% CI 1.12-1.43)[7]
↑ spinal fractures OR = 1.60 (95% CI 1.25-2.04) [8] 		Association with duration of therapy
  • AOR 1 year, 1.22 (1.15-1.30)
  • AOR 2 years, 1.41 (1.28-1.56)
  • AOR 3 years, 1.54 (1.37-1.73)
  • AOR 4 years, 1.59 (1.39-1.80)[9]


Is likely to be ineffective or harmful with moderate quality evidence

level 3b
H2 antagonists ↓ any fracture OR=0.88 (95% CI 0.82-0.95)[10]
↓ hip fracture OR = 0.69 (95% CI 0.57-0.84)[11] 		Is likely to be beneficial with low quality evidence level 3b
Warfarin In men ↑ OR=1.63 (95% CI 1.26-2.10)[12]

no association in woman OR=1.05 (95% CI 0.88-1.26) [13]

Is low quality evidence and unlikely to be benefical level 3b
Paracetamol ↑ OR=1.45 (95% CI 1.41-1.49)[14] Thus unknown effectiveness and low quality evidence. There are known associations with osteoarthritis and rheumatoid arthritis[15] level 3b
Ibuprofen ↑ OR=2.09 (95% CI 2.00-2.18)[16] As NSAID analysis for association with fracture is heterogeneous and there are known associations with osteoarthritis and rheumatoid arthritis[17] is low quality evidence. level 3b
Narcotics ↑ in women HR=1.40 (95% CI 1.06-1.83)[18] Is unlikely to be benefical with suggestive correlation to drug properties level 3b
Tramadol ↑ OR=1.54 (95% CI 1.49-1.58)[27] Is unlikely to be benefical and low quality evidence. level 3b
Antidepressants ↑OR=1.40 (95% CI 1.35-1.46)[28]
older women fractures HR=1.25 (95% CI 0.99-1.58)[29]
hip fractures HR=1.65 (95% CI 1.05-2.57) [30] 		Is likely to be ineffective or harmful and high quality evidence and has dose response curve level 3b
SSRIs ↑[31] see antidepressants. Is likely to be ineffective or harmful and moderate quality evidence. level 3b
Tricyclic antidepressants ↑[32] see antidepressants. Is unlikely to be benefical and moderate quality evidence. level 3b
Major tranquillisers ↑ 3 fold increased risk of hip fracture [33] [34] Is unlikely to be benefical and and moderate quality evidence. ? role drug induced parkinsonism level 3b
Antiparkinson's medications ↑ Nearly 4-fold increased risk of hip fracture.[35] Is unlikely to be benefical and moderate quality evidence. May well be indirect association due to parkinsonism level 3b
Anxiolytics or sedatives ↑[36]
Benzodiazepine use is not clearly associated in older women [37] 		Is unlikely to be benefical and moderate quality evidence. level 3b
Anticonvulsants Use is not clearly associated in older women[38] Is unlikely to be benefical and low quality evidence. level 3b
Lithium ↓ Lithium 250 to 850mg od OR=0.74 (95% CI 0.60-0.92), more than 850mg od OR=0.67 (95% CI 0.55-0.81) [39] Is trade off between benefits and harms and likely to be beneficial level 3b
Strontium RR about 0.7 depending upon patient population [40] Is beneficial in reducing hip and vertebral fractures level 1a
Bisphosphonates RR about 0.7 depending upon patient population[41] Is beneficial in reducing hip and vertebral fractures level 1a
Vitamin D Ineffectual in normal populations.[42] Is likely to be beneficial in instituationalised elderly. level 1a
Hormone replacement therapy Typically OR=0.77 (95% CI 0.73-0.82) [43] Due to risk of thrombotic events likely to be ineffective or harmful level 1a
Statins ↓ any fracture prior 180 days AOR=0.50 (95% CI 0.33-0.76)
↓ prior 3 years AOR= 0.57(95% CI 0.40-0.82)
↓current use AOR 0.29 (95% CI 0.10-0.81)[44] AOR=0.55; 95% CI 0.44-0.69)[45], AOR=0.87 (95% CI 0.83-0.92)[46]
↓ hip fracture AOR=0.57 (95% CI 0.48-0.69)[47], OR=0.68(95% CI 0.50-0.93)[48] 		One study reports pravastatin not associated with reduced fracture risk AOR=1.02 (95% CI, 0.89-1.17)[49] Is unknown effectiveness as the statistically significant improvement in hip fracture risk was seen only in case-control trials, not in either the eight prospective trials or the two randomized controlled trials (RCTs).[50] [51] level 3a
Fibrates No effect AOR=0.87 (95% CI 0.70-1.08)[52] No effect for non statin other lipid lowering agents too AOR=0.99 (95% CI, 0.86-1.15)[53]. level 3b
Beta-blockers ↓OR= 0.91 (95% CI 0.88-0.93) [54]RR=0.86 (95% CI 0.70-0.98)[55]
↓ current use of beta-blockers OR= 0.77 (95% CI 0.72-0.83)[56] 		Is moderate quality evidence and unknown effectiveness. level 3a
Calcium-channel blockers ↓OR=0.94 (95% CI 0.91-0.96)[57] Is low quality evidence and unknown effectiveness. level 3b
Thiazide diuretics ↓ any fracture RR=0.86 (95% CI 0.81-0.92) [58], OR=0.80 (95% CI 0.74-0.86)[59], OR=0.90 (95% CI 0.88-0.93)[60]
↓ forearm fracture OR=0.83 (95% CI 0.77-0.89)[61] 		Is moderate quality evidence for trade off between benefits and harms. level 3a
ACE inhibitors ↓ OR=0.93 (95% CI 0.90-0.96)[62] Is low quality evidence. level 3b
Low dose Aspirin No effect[63] Is low quality evidence level 3b
Thyroxine No effect in females hip fracture AOR=1.03(95% CI, 0.92-1.16)[64]
↑ in males AOR=1.69( 95% CI 1.12-2.56, P =.01)[65] 		Is moderate quality evidence. level 3b[66]
Alcohol Hip fracture in females AOR=3.05(95% CI 1.94-4.76; P<.001)[67]
Any fracture OR=0.80 (95% CI 0.69-0.93)[68] 		low quality evidence in women, moderate quality evidence in men. Is level 3b
Smoking Fracture OR=1.66 ( 95% CI 1.41-1.95)[69] Is moderate quality evidence level 3b

References

  1. ↑ Albrand G, Munoz F, Sornay-Rendu E, DuBoeuf F, Delmas PD. Independent predictors of all osteoporosis-related fractures in healthy postmenopausal women: the OFELY study. Bone 2003;32:78-85.
  2. ↑ Lewis CE, Ewing SK, Taylor BC, Shikany JM, Fink HA, Ensrud KE, et al. Predictors of Non-Spine Fracture in Elderly Men: The MrOS Study. Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research 2007;22:211-9. (Direct link – subscription may be required.)
  3. ↑ Vestergaard P, Olsen ML, Paaske Johnsen S, Rejnmark L, Sørensen HT, Mosekilde L. Corticosteroid use and risk of hip fracture: a population-based case-control study in Denmark. Journal of internal medicine 2003;254:486-93.
  4. ↑ Vestergaard P, Olsen ML, Paaske Johnsen S, Rejnmark L, Sørensen HT, Mosekilde L. Corticosteroid use and risk of hip fracture: a population-based case-control study in Denmark. Journal of internal medicine 2003;254:486-93.
  5. ↑ Yang YX, Lewis JD, Epstein S, Metz DC. Long-term proton pump inhibitor therapy and risk of hip fracture. JAMA : the journal of the American Medical Association 2006;296:2947-53. (Direct link – subscription may be required.)
  6. ↑ Vestergaard P, Rejnmark L, Mosekilde L.Proton pump inhibitors, histamine H2 receptor antagonists, and other antacid medications and the risk of fracture. Calcif Tissue Int. 2006 Aug;79(2):76-83
  7. ↑ Vestergaard P, Rejnmark L, Mosekilde L.Proton pump inhibitors, histamine H2 receptor antagonists, and other antacid medications and the risk of fracture. Calcif Tissue Int. 2006 Aug;79(2):76-83
  8. ↑ Vestergaard P, Rejnmark L, Mosekilde L.Proton pump inhibitors, histamine H2 receptor antagonists, and other antacid medications and the risk of fracture. Calcif Tissue Int. 2006 Aug;79(2):76-83
  9. ↑ Yang YX, Lewis JD, Epstein S, Metz DC. Long-term proton pump inhibitor therapy and risk of hip fracture. JAMA : the journal of the American Medical Association 2006;296:2947-53. (Direct link – subscription may be required.)
  10. ↑ Vestergaard P, Rejnmark L, Mosekilde L.Proton pump inhibitors, histamine H2 receptor antagonists, and other antacid medications and the risk of fracture. Calcif Tissue Int. 2006 ;79(2):76-83 link to article subscription may be required
  11. ↑ Vestergaard P, Rejnmark L, Mosekilde L.Proton pump inhibitors, histamine H2 receptor antagonists, and other antacid medications and the risk of fracture. Calcif Tissue Int. 2006 ;79(2):76-83 link to article subscription may be required
  12. ↑ Gage BF, Birman-Deych E, Radford MJ, Nilasena DS, Binder EF. Risk of osteoporotic fracture in elderly patients taking warfarin: results from the National Registry of Atrial Fibrillation 2. Archives of internal medicine 2006;166:241-6. (Direct link – subscription may be required.)
  13. ↑ Gage BF, Birman-Deych E, Radford MJ, Nilasena DS, Binder EF. Risk of osteoporotic fracture in elderly patients taking warfarin: results from the National Registry of Atrial Fibrillation 2. Archives of internal medicine 2006;166:241-6. (Direct link – subscription may be required.)
  14. ↑ Vestergaard P, Rejnmark L, Mosekilde L. Fracture risk associated with use of nonsteroidal anti-inflammatory drugs, acetylsalicylic acid, and acetaminophen and the effects of rheumatoid arthritis and osteoarthritis.Calcif Tissue Int. 2006;79(2):84-94 link to article subscription may be required
  15. ↑ Vestergaard P, Rejnmark L, Mosekilde L. Fracture risk associated with use of nonsteroidal anti-inflammatory drugs, acetylsalicylic acid, and acetaminophen and the effects of rheumatoid arthritis and osteoarthritis.Calcif Tissue Int. 2006;79(2):84-94 link to article subscription may be required
  16. ↑ Vestergaard P, Rejnmark L, Mosekilde L. Fracture risk associated with use of nonsteroidal anti-inflammatory drugs, acetylsalicylic acid, and acetaminophen and the effects of rheumatoid arthritis and osteoarthritis.Calcif Tissue Int. 2006;79(2):84-94 link to article subscription may be required
  17. ↑ Vestergaard P, Rejnmark L, Mosekilde L. Fracture risk associated with use of nonsteroidal anti-inflammatory drugs, acetylsalicylic acid, and acetaminophen and the effects of rheumatoid arthritis and osteoarthritis.Calcif Tissue Int. 2006;79(2):84-94 link to article subscription may be required
  18. ↑ Ensrud KE, Blackwell T, Mangione CM, Bowman PJ, Bauer DC, Schwartz A, et al. Central nervous system active medications and risk for fractures in older women. Archives of internal medicine 2003;163:949-57. (Direct link – subscription may be required.)
  19. ↑ Vestergaard P, Rejnmark L, Mosekilde L. Fracture risk associated with the use of morphine and opiates. Journal of internal medicine 2006;260:76-87. (Direct link – subscription may be required.)
  20. ↑ Vestergaard P, Rejnmark L, Mosekilde L. Fracture risk associated with the use of morphine and opiates. Journal of internal medicine 2006;260:76-87. (Direct link – subscription may be required.)
  21. ↑ Vestergaard P, Rejnmark L, Mosekilde L. Fracture risk associated with the use of morphine and opiates. Journal of internal medicine 2006;260:76-87. (Direct link – subscription may be required.)
  22. ↑ Vestergaard P, Rejnmark L, Mosekilde L. Fracture risk associated with the use of morphine and opiates. Journal of internal medicine 2006;260:76-87. (Direct link – subscription may be required.)
  23. ↑ Vestergaard P, Rejnmark L, Mosekilde L. Fracture risk associated with the use of morphine and opiates. Journal of internal medicine 2006;260:76-87. (Direct link – subscription may be required.)
  24. ↑ Vestergaard P, Rejnmark L, Mosekilde L. Fracture risk associated with the use of morphine and opiates. Journal of internal medicine 2006;260:76-87. (Direct link – subscription may be required.)
  25. ↑ Vestergaard P, Rejnmark L, Mosekilde L. Fracture risk associated with the use of morphine and opiates. Journal of internal medicine 2006;260:76-87. (Direct link – subscription may be required.)
  26. ↑ Vestergaard P, Rejnmark L, Mosekilde L. Fracture risk associated with the use of morphine and opiates. Journal of internal medicine 2006;260:76-87. (Direct link – subscription may be required.)
  27. ↑ Vestergaard P, Rejnmark L, Mosekilde L. Fracture risk associated with the use of morphine and opiates. Journal of internal medicine 2006;260:76-87. (Direct link – subscription may be required.)
  28. ↑ P. Vestergaard1, L. Rejnmark, L. Mosekilde. Anxiolytics, sedatives, antidepressants, neuroleptics and the risk of fracture. Osteoporos Int. 2006;17(6):807-16. link to article subscription required
  29. ↑ Ensrud KE, Blackwell T, Mangione CM, Bowman PJ, Bauer DC, Schwartz A, et al. Central nervous system active medications and risk for fractures in older women. Archives of internal medicine 2003;163:949-57. (Direct link – subscription may be required.)
  30. ↑ Ensrud KE, Blackwell T, Mangione CM, Bowman PJ, Bauer DC, Schwartz A, et al. Central nervous system active medications and risk for fractures in older women. Archives of internal medicine 2003;163:949-57. (Direct link – subscription may be required.)
  31. ↑ P. Vestergaard1, L. Rejnmark, L. Mosekilde. Anxiolytics, sedatives, antidepressants, neuroleptics and the risk of fracture. Osteoporos Int. 2006;17(6):807-16. link to article subscription required
  32. ↑ P. Vestergaard1, L. Rejnmark, L. Mosekilde. Anxiolytics, sedatives, antidepressants, neuroleptics and the risk of fracture. Osteoporos Int. 2006;17(6):807-16. link to article subscription required
  33. ↑ French DD, Campbell R, Spehar A, Cunningham F, Foulis P. Outpatient medications and hip fractures in the US: a national veterans study. Drugs &amp;amp; aging 2005;22:877-85.
  34. ↑ P. Vestergaard1, L. Rejnmark, L. Mosekilde. Anxiolytics, sedatives, antidepressants, neuroleptics and the risk of fracture. Osteoporos Int. 2006;17(6):807-16. link to article subscription required
  35. ↑ French DD, Campbell R, Spehar A, Cunningham F, Foulis P. Outpatient medications and hip fractures in the US: a national veterans study. Drugs &amp;amp; aging 2005;22:877-85.
  36. ↑ P. Vestergaard1, L. Rejnmark, L. Mosekilde. Anxiolytics, sedatives, antidepressants, neuroleptics and the risk of fracture. Osteoporos Int. 2006;17(6):807-16. link to article subscription required
  37. ↑ Ensrud KE, Blackwell T, Mangione CM, Bowman PJ, Bauer DC, Schwartz A, et al. Central nervous system active medications and risk for fractures in older women. Archives of internal medicine 2003;163:949-57. (Direct link – subscription may be required.)
  38. ↑ Ensrud KE, Blackwell T, Mangione CM, Bowman PJ, Bauer DC, Schwartz A, et al. Central nervous system active medications and risk for fractures in older women. Archives of internal medicine 2003;163:949-57. (Direct link – subscription may be required.)
  39. ↑ Vestergaard P, Rejnmark L, Mosekilde L. Reduced relative risk of fractures among users of lithium. Calcified tissue international 2005;77:1-8. (Direct link – subscription may be required.),
  40. ↑ ODonnell S, Cranney A, Wells GA, Adachi JD, Reginster JY. Strontium ranelate for preventing and treating postmenopausal osteoporosis. Cochrane Database of Systematic Reviews 2006, Issue 4. Art. No.: CD005326. DOI: 10.1002/14651858.CD005326.pub3. link to Cochrane review
  41. ↑ Homik J, Cranney A, Shea B, Tugwell P, Wells G, Adachi JD, Suarez-Almazor ME. Bisphosphonates for steroid induced osteoporosis. Cochrane Database of Systematic Reviews 1999, Issue 1. Art. No.: CD001347. DOI: 10.1002/14651858.CD001347.
  42. ↑ Avenell A, Gillespie WJ, Gillespie LD, OConnell DL. Vitamin D and vitamin D analogues for preventing fractures associated with involutional and post-menopausal osteoporosis. Cochrane Database of Systematic Reviews 2005, Issue 3. Art. No.: CD000227. DOI:10.1002/14651858.CD000227.pub2. link to Cochrane Review
  43. ↑ Vestergaard P, Rejnmark L, Mosekilde L. Fracture reducing potential of hormone replacement therapy on a population level. Maturitas. 2006;54(3):285-93
  44. ↑ Wang PS, Solomon DH, Mogun H, Avorn J. HMG-CoA reductase inhibitors and the risk of hip fractures in elderly patients. JAMA : the journal of the American Medical Association 2000;283:3211-6.
  45. ↑ Meier CR, Schlienger RG, Kraenzlin ME, Schlegel B, Jick H. HMG-CoA reductase inhibitors and the risk of fractures. JAMA : the journal of the American Medical Association 2000;283:3205-10.
  46. ↑ Rejnmark L, Vestergaard P, Mosekilde L. Statin but not non-statin lipid-lowering drugs decrease fracture risk: a nation-wide case-control study. Calcified tissue international 2006;79:27-36. (Direct link – subscription may be required.)
  47. ↑ Rejnmark L, Vestergaard P, Mosekilde L. Statin but not non-statin lipid-lowering drugs decrease fracture risk: a nation-wide case-control study. Calcified tissue international 2006;79:27-36. (Direct link – subscription may be required.)
  48. ↑ Rejnmark L, Olsen ML, Johnsen SP, Vestergaard P, Sørensen HT, Mosekilde L. Hip fracture risk in statin users--a population-based Danish case-control study. Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA 2004;15:452-8. (Direct link – subscription may be required.)
  49. ↑ Rejnmark L, Vestergaard P, Mosekilde L. Statin but not non-statin lipid-lowering drugs decrease fracture risk: a nation-wide case-control study. Calcified tissue international 2006;79:27-36. (Direct link – subscription may be required.)
  50. ↑ Hatzigeorgiou C, Jackson JL. Hydroxymethylglutaryl-coenzyme A reductase inhibitors and osteoporosis: a meta-analysis. Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA 2005;16:990-8. (Direct link – subscription may be required.)
  51. ↑ Bauer DC, Mundy GR, Jamal SA, Black DM, Cauley JA, Ensrud KE, et al. Use of statins and fracture: results of 4 prospective studies and cumulative meta-analysis of observational studies and controlled trials. Archives of internal medicine 2004;164:146-52. (Direct link – subscription may be required.)
  52. ↑ Meier CR, Schlienger RG, Kraenzlin ME, Schlegel B, Jick H. HMG-CoA reductase inhibitors and the risk of fractures. JAMA : the journal of the American Medical Association 2000;283:3205-10.
  53. ↑ Rejnmark L, Vestergaard P, Mosekilde L. Statin but not non-statin lipid-lowering drugs decrease fracture risk: a nation-wide case-control study. Calcified tissue international 2006;79:27-36. (Direct link – subscription may be required.)
  54. ↑ Rejnmark L, Vestergaard P, Mosekilde L. Treatment with beta-blockers, ACE inhibitors, and calcium-channel blockers is associated with a reduced fracture risk: a nationwide case-control study. Journal of hypertension 2006;24:581-9. (Direct link – subscription may be required.)
  55. ↑ Wiens M, Etminan M, Gill SS, Takkouche B. Effects of antihypertensive drug treatments on fracture outcomes: a meta-analysis of observational studies. Journal of internal medicine 2006;260:350-62. (Direct link – subscription may be required.)
  56. ↑ Schlienger RG, Kraenzlin ME, Jick SS, Meier CR. Use of beta-blockers and risk of fractures. JAMA : the journal of the American Medical Association 2004;292:1326-32. (Direct link – subscription may be required.)
  57. ↑ Rejnmark L, Vestergaard P, Mosekilde L. Treatment with beta-blockers, ACE inhibitors, and calcium-channel blockers is associated with a reduced fracture risk: a nationwide case-control study. Journal of hypertension 2006;24:581-9. (Direct link – subscription may be required.)
  58. ↑ Wiens M, Etminan M, Gill SS, Takkouche B. Effects of antihypertensive drug treatments on fracture outcomes: a meta-analysis of observational studies. Journal of internal medicine 2006;260:350-62. (Direct link – subscription may be required.)
  59. ↑ Schlienger RG, Kraenzlin ME, Jick SS, Meier CR. Use of beta-blockers and risk of fractures. JAMA : the journal of the American Medical Association 2004;292:1326-32. (Direct link – subscription may be required.)
  60. ↑ Rejnmark L, Vestergaard P, Mosekilde L. Reduced fracture risk in users of thiazide diuretics. Calcified tissue international 2005;76:167-75. (Direct link – subscription may be required.)
  61. ↑ Rejnmark L, Vestergaard P, Mosekilde L. Reduced fracture risk in users of thiazide diuretics. Calcified tissue international 2005;76:167-75. (Direct link – subscription may be required.)
  62. ↑ Rejnmark L, Vestergaard P, Mosekilde L. Treatment with beta-blockers, ACE inhibitors, and calcium-channel blockers is associated with a reduced fracture risk: a nationwide case-control study. Journal of hypertension 2006;24:581-9. (Direct link – subscription may be required.)
  63. ↑ Vestergaard P, Rejnmark L, Mosekilde L. Fracture risk associated with use of nonsteroidal anti-inflammatory drugs, acetylsalicylic acid, and acetaminophen and the effects of rheumatoid arthritis and osteoarthritis.Calcif Tissue Int. 2006;79(2):84-94 link to article subscription may be required
  64. ↑ Sheppard MC, Holder R, Franklyn JA. Levothyroxine treatment and occurrence of fracture of the hip. Archives of internal medicine 2002;162:338-43.
  65. ↑ Sheppard MC, Holder R, Franklyn JA. Levothyroxine treatment and occurrence of fracture of the hip. Archives of internal medicine 2002;162:338-43.
  66. ↑ Sheppard MC, Holder R, Franklyn JA. Levothyroxine treatment and occurrence of fracture of the hip. Archives of internal medicine 2002;162:338-43.
  67. ↑ Baron JA, Farahmand BY, Weiderpass E, Michaëlsson K, Alberts A, Persson I, et al. Cigarette smoking, alcohol consumption, and risk of hip fracture in women. Archives of internal medicine 2001;161:983-8.
  68. ↑ Baron JA, Farahmand BY, Weiderpass E, Michaëlsson K, Alberts A, Persson I, et al. Cigarette smoking, alcohol consumption, and risk of hip fracture in women. Archives of internal medicine 2001;161:983-8.
  69. ↑ Baron JA, Farahmand BY, Weiderpass E, Michaëlsson K, Alberts A, Persson I, et al. Cigarette smoking, alcohol consumption, and risk of hip fracture in women. Archives of internal medicine 2001;161:983-8.
Retrieved from "http://www.ganfyd.org/index.php?title=Associations_between_Drugs_and_Fractures"
Personal tools