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Vestergaard P et al. – Bisphosphonates seem associated with an increased risk of DVT/PE. However, the association does not seem to be causal.

Methods

Nationwide register-based cohort study from Denmark with all users of bisphosphonates and other drugs against osteoporosis between 1996 and 2006 as cases and three age- and gender-matched controls from the general population

Results

Before start of drug against osteoporosis, increased risk of DVT/PE present in crude analysis for alendronate, etidronate, and risedronate
Upon adjustment, increase in risk disappeared
Before start of raloxifene, decreased risk of DVT/PE present (odds ratio (OR)?=?0.53, 95% confidence interval (CI), 0.39–0.71)
After start of drug, alendronate , clodronate , and etidronate (HR?=?1–37, 95% CI, 1.23–1.51) were all associated with an increased risk of DVT/PE, while raloxifene was only borderline, significantly associated with risk of DVT/PE
No dose–reponse relationship present except for alendronate, where risk was inversely associated with dose, i.e., risk of DVT/PE decreased with increasing average daily dose
Alendronate and raloxifene carried same risk for DVT/PE

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