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[Anticoagulant and bone fragility: which implications for clinical practice?]

Anne Pelet1, Olivier Lamy1,2

  • 1Centre interdisciplinaire des maladies osseuses, CHUV, 1011 lausanne.

Revue Medicale Suisse
|April 21, 2021
PubMed

Insights

Vitamin K antagonists (VKA) may increase fracture risk in patients needing anticoagulation. New oral anticoagulants (NOACs) show a lower risk, making them a potential alternative for fracture-prone individuals.

Area of Science:

  • Pharmacology
  • Orthopedics
  • Gerontology

Background:

  • Bone fragility is linked to certain medical treatments.
  • Long-term use of vitamin K antagonists (VKA) has been associated with an increased risk of osteoporotic fractures since the 2000s.

Purpose of the Study:

  • To evaluate the fracture risk associated with new oral anticoagulants (NOACs) compared to VKAs.
  • To inform anticoagulant selection for patients at risk of fractures.

Main Methods:

  • Comparative analysis of fracture incidence in patients using VKAs versus NOACs.
  • Review of existing literature and clinical data on anticoagulant-associated fracture risk.

Main Results:

  • New oral anticoagulants (NOACs) are associated with a lower fracture risk compared to vitamin K antagonists (VKA).

Conclusions:

  • NOACs represent a potentially safer alternative for long-term anticoagulation in patients with fracture risk factors.
  • Further research is needed to fully elucidate the long-term skeletal effects of NOACs.

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