TY - JOUR
T1 - Effect of non-steroidal anti-inflammatory drugs on bone turnover
T2 - An evidence-based review
AU - Konstantinidis, Ioannis
AU - Papageorgiou, Spyridon N.
AU - Kyrgidis, Athanassios
AU - Tzellos, Thrasivoulos George
AU - Kouvelas, Dimitrios
PY - 2013
Y1 - 2013
N2 - Nonsteroidal anti-inflammatory drugs (NSAIDs) are frequently used for acute and chronic pain control and treatment of inflammation, osteoarthritis and rheumatoid arthritis. NSAIDs have been shown to inhibit bone healing in animal studies due to the inhibition of prostaglandin synthesis. However, little evidence exists regarding the effect of NSAID exposure on human bone metabolism. This systematic review summarizes the current literature of randomized controlled trials (RCTs) investigating NSAIDs with bone remodeling-related outcomes in humans. After performing computerized searches in the most widely indexed databases, study selection, data abstraction and risk of bias assessment were conducted in duplicate. The results were controversial regarding the association of NSAID with bone formation or resorption. Increased bone mineral density following NSAID exposure was reported by some studies. Based on the levels of biochemical markers, no effect was seen on bone formation, while some evidence was found for a decreased rate of bone resorption in NSAID patients. Trials investigating the effects of NSAID treatment on bone metabolism outcomes of human patients are limited. Further research is required to confirm or refute the findings of this systematic review.
AB - Nonsteroidal anti-inflammatory drugs (NSAIDs) are frequently used for acute and chronic pain control and treatment of inflammation, osteoarthritis and rheumatoid arthritis. NSAIDs have been shown to inhibit bone healing in animal studies due to the inhibition of prostaglandin synthesis. However, little evidence exists regarding the effect of NSAID exposure on human bone metabolism. This systematic review summarizes the current literature of randomized controlled trials (RCTs) investigating NSAIDs with bone remodeling-related outcomes in humans. After performing computerized searches in the most widely indexed databases, study selection, data abstraction and risk of bias assessment were conducted in duplicate. The results were controversial regarding the association of NSAID with bone formation or resorption. Increased bone mineral density following NSAID exposure was reported by some studies. Based on the levels of biochemical markers, no effect was seen on bone formation, while some evidence was found for a decreased rate of bone resorption in NSAID patients. Trials investigating the effects of NSAID treatment on bone metabolism outcomes of human patients are limited. Further research is required to confirm or refute the findings of this systematic review.
KW - Bone metabolism
KW - Bone remodeling
KW - Non-steroidal anti-inflammatory drug
KW - Randomized controlled trial
UR - http://www.scopus.com/inward/record.url?scp=84874867318&partnerID=8YFLogxK
U2 - 10.2174/1574887111308010008
DO - 10.2174/1574887111308010008
M3 - Article
C2 - 23016823
AN - SCOPUS:84874867318
SN - 1574-8871
VL - 8
SP - 48
EP - 60
JO - Reviews on Recent Clinical Trials
JF - Reviews on Recent Clinical Trials
IS - 1
ER -