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Association between bisphosphonate use and stroke risk: a meta-analysis
Shu-Man Lin1,2, Jhe-Yi Lin3, Yu-Kang Tu4,5
1Department of Physical Medicine and Rehabilitation, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.
Summary
Bisphosphonates may lower stroke risk, but evidence is inconclusive. Randomized controlled trials found no significant association, indicating a need for further high-quality research to confirm causality.
Area of Science:
- Pharmacological interventions in cerebrovascular disease.
- Epidemiological studies on stroke risk factors.
Background:
- Previous research suggested bisphosphonates might reduce stroke risk.
- The association between bisphosphonate use and stroke risk remains uncertain.
Approach:
- A systematic review and meta-analysis evaluated up-to-date evidence.
- Searched major databases (PubMed, Embase, Scopus, Cochrane) for relevant studies.
- Included 21 studies with 741,274 participants, analyzing randomized controlled trials and observational studies.
Key Points:
- Overall meta-analysis showed a borderline significant association between bisphosphonate use and lower stroke risk (RR=0.87, p=0.048).
- High heterogeneity was observed across studies (I²=83.7%).
- Subgroup analysis of 7 randomized controlled trials found no statistically significant association (RR=0.93, p=0.462).
Conclusions:
- Current evidence suggests a potential link between bisphosphonates and reduced stroke risk.
- Borderline significance and high heterogeneity limit definitive conclusions.
- High-quality randomized controlled trials are essential to establish causality.
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