Oral anticoagulants and the risk of osteoporotic fractures among elderly

@article{Pilon2004OralAA,
  title={Oral anticoagulants and the risk of osteoporotic fractures among elderly},
  author={Danielle Pilon and A M Castilloux and Marc Dorais and Jacques LeLorier},
  journal={Pharmacoepidemiology and Drug Safety},
  year={2004},
  volume={13}
}
Coumadin‐based oral anticoagulants are associated with a decrease in bone mass density, but their role in fracture risk is equivocal. Because the use of oral anticoagulants is prevalent among the elderly, as is the risk and morbidity of osteoporotic fractures, the association between osteoporotic fractures and oral anticoagulants needs to be clarified. 
Single‐Point Assessment of Warfarin Use and Risk of Osteoporosis in Elderly Men
TLDR
To determine whether warfarin use, assessed at a single point in time, is associated with bone mineral density, rates of bone loss, and fracture risk in older men, a large number of men in their 60s and 70s are surveyed.
Vitamin K antagonists' use and fracture risk: results from a systematic review and meta‐analysis
Although vitamin K antagonists (VKAs) lower serum values of bone deposition markers, the link with osteoporosis and fractures remains controversial.
Risk of osteoporotic fracture in elderly patients taking warfarin: results from the National Registry of Atrial Fibrillation 2.
TLDR
Long-term use of warfarin was associated with osteoporotic fractures, at least in men with atrial fibrillation, and beta-adrenergic antagonists may protect against osteopootic fractures.
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TLDR
The use of NOACs was associated with a lower risk of fracture compared to warfarin, but with a relatively low absolute risk reduction, and screening for the fracture risk should be considered before initiating anticoagulation treatment.
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TLDR
The research suggests that at a minimum, clinicians should carefully assess anticoagulated patients for osteoporosis risk, monitor BMD, and refer them to dietitians for dietary and supplement advice on bone health.
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TLDR
On the basis of the present mechanistic insight relating to skeletal adaptation to mechanical loading, further investigation about the adverse effect of vitamin K antagonists on fracture risk could not be required in patients with normal physical activity, as suggested by the authors.
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TLDR
In elderly patients, attending an ED, warfarin sodium use does not seem to be a risk factor for an osteoporotic fracture.
Systematic DOACs oral anticoagulation in patients with atrial fibrillation and chronic kidney disease: the nephrologist’s perspective
TLDR
DOAC therapy should be considered as the first line therapy for non valvular AF in patients with mild and moderate reduction of renal function, and could also be adopted for patients with severe CKD not on hemodialysis treatment, whereas there is insufficient evidence for ESRD patients on dialysis.
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