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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Published in	International journal of molecular sciences Vol. 20; no. 21; p. 5275
Main Authors	Signorelli, Salvatore Santo, Scuto, Salvatore, Marino, Elisa, Giusti, Michele, Xourafa, Anastasia, Gaudio, Agostino
Format	Journal Article
Language	English
Published	Switzerland MDPI AG 24.10.2019 MDPI
Subjects	Anticoagulants Anticoagulants - adverse effects Anticoagulants - pharmacology Anticoagulants - therapeutic use Bone and Bones - drug effects Bone and Bones - metabolism Bone density Bone Density - drug effects Disease prevention Drug dosages Fractures Fractures, Bone - etiology Heparin, Low-Molecular-Weight - adverse effects Heparin, Low-Molecular-Weight - pharmacology Heparin, Low-Molecular-Weight - therapeutic use Humans Metabolism Molecular weight Osteoporosis Osteoporosis - etiology Phosphatase Review Stroke Thromboembolism Venous Thromboembolism - drug therapy heparin low molecular weight heparins (LMWHs) osteoporosis anticoagulant agents fracture warfarin
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ISSN	1422-0067 1661-6596 1422-0067
DOI	10.3390/ijms20215275

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Abstract	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.
AbstractList	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. 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.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.
Author	Xourafa, Anastasia Gaudio, Agostino Scuto, Salvatore Signorelli, Salvatore Santo Marino, Elisa Giusti, Michele
AuthorAffiliation	Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy; salvo.scuto1982@hotmail.it (S.S.); marinoelisa@msn.com (E.M.); michelegiusti88@gmail.com (M.G.); axourafa@gmail.com (A.X.); agostino.gaudio@gmail.com (A.G.)
AuthorAffiliation_xml	– name: Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy; salvo.scuto1982@hotmail.it (S.S.); marinoelisa@msn.com (E.M.); michelegiusti88@gmail.com (M.G.); axourafa@gmail.com (A.X.); agostino.gaudio@gmail.com (A.G.)
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Copyright	2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. 2019 by the authors. 2019
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Snippet	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...
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SubjectTerms	Anticoagulants Anticoagulants - adverse effects Anticoagulants - pharmacology Anticoagulants - therapeutic use Bone and Bones - drug effects Bone and Bones - metabolism Bone density Bone Density - drug effects Disease prevention Drug dosages Fractures Fractures, Bone - etiology Heparin, Low-Molecular-Weight - adverse effects Heparin, Low-Molecular-Weight - pharmacology Heparin, Low-Molecular-Weight - therapeutic use Humans Metabolism Molecular weight Osteoporosis Osteoporosis - etiology Phosphatase Review Stroke Thromboembolism Venous Thromboembolism - drug therapy
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Title	Anticoagulants and Osteoporosis
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