A Meta-analysis Of The Increased Risk Of Fractures With Opioids

Objective:To assess the relationship between opioid therapy for chronic noncancer pain and fracture risk by performing a meta-analysis of cohort studies and case-control studiesMethods:The included cohort studies and case-control studies were identified by searching the PubMed,EMBASE,Cochrane,Ovid,and Web of Science databases from their inception until Jan 1,2020.The outcome of interest was fracture,this information was independently screened by two authors.When the heterogeneity among studies was significant,a random effects model was used to determine the overall combined risk estimateResults:In total,12 cohort studies and 6 case-control studies were included.We used the Newcastle-Ottawa Scale(NOS)to evaluate the quality of the included literature,and 14 of the studies were considered high-quality studies.The overall relative risk of opioid therapy and fractures was 1.78(95%confidence interval(CI)1.53-2.07).Subgroup analyses revealed the sources of heterogeneity,and the sensitivity analysis was stable,Additionally,no publication bias was observed.Conclusion:The meta-analysis showed that the use of opioids significantly increased the risk of fracture.