Anticoagulants and Osteoporosis

Anticoagulant agents are widely used in the treatment of thromboembolic events and in stroke prevention. Data about their effects on bone tissue are in some cases limited or inconsistent (oral anti-vitamin K agents), and in others are sufficiently strong (heparins) to suggest caution in their use in...

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Bibliographic Details
Published in:International journal of molecular sciences 2019-10, Vol.20 (21), p.5275
Main Authors: Signorelli, Salvatore Santo, Scuto, Salvatore, Marino, Elisa, Giusti, Michele, Xourafa, Anastasia, Gaudio, Agostino
Format: Article
Language:English
Subjects:
anticoagulant agents
Anticoagulants
Anticoagulants - adverse effects
Anticoagulants - pharmacology
Anticoagulants - therapeutic use
Biomedical materials
Bone and Bones - drug effects
Bone and Bones - metabolism
Bone density
Bone Density - drug effects
Bone mineral density
Bone turnover
Disease prevention
Drug dosages
Drug metabolism
fracture
Fractures
Fractures, Bone - etiology
Fragility
Heparin
Heparin, Low-Molecular-Weight - adverse effects
Heparin, Low-Molecular-Weight - pharmacology
Heparin, Low-Molecular-Weight - therapeutic use
Humans
low molecular weight heparins (lmwhs)
Low molecular weights
Metabolism
Molecular weight
Osteocalcin
Osteoporosis
Osteoporosis - etiology
Phosphatase
Phylloquinone
Review
Stroke
Thromboembolism
Venous Thromboembolism - drug therapy
Vitamin K
warfarin
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Summary:Anticoagulant agents are widely used in the treatment of thromboembolic events and in stroke prevention. Data about their effects on bone tissue are in some cases limited or inconsistent (oral anti-vitamin K agents), and in others are sufficiently strong (heparins) to suggest caution in their use in subjects at risk of osteoporosis. This review analyses the effects of this group of drugs on bone metabolism, on bone mineral density, and on fragility fractures. A literature search strategy was developed by an experienced team of specialists by consulting the MEDLINE platform, including published papers and reviews updated to March 2019. Literature supports a detrimental effect of heparin on bone, with an increase in fracture rate. Low molecular weight heparins (LMWHs) seem to be safer than heparin. Although anti-vitamin K agents (VKAs) have a significant impact on bone metabolism, and in particular, on osteocalcin, data on bone mineral density (BMD) and fractures are contrasting. To date, the new direct oral anticoagulants (DOACs) are found to safe for bone health.
ISSN:1422-0067
1661-6596
1422-0067
DOI:10.3390/ijms20215275