Gabapentinoids may raise risk of hip fractures

Use of gabapentinoids appears to contribute to an increase in the risk of hip fractures, especially for patients who are frail or have chronic kidney disease (CKD), according to a study.

Researchers used conditional logistic regression models to estimate the association between hip fractures and gabapentinoid dispensing in the index (1–60 days prefracture) versus the reference (121–180 days prefracture) period. They also conducted analyses in subgroups defined by CKD status and frailty scores (Hospital Frailty Risk Score [HFRS] <5 vs ≥5).

Of the 28,293 patients hospitalized for hip fractures, 2,946 (59.5 percent aged ≥80 years, 71.2 percent female) were dispensed a gabapentinoid prior to hospital admission. A total of 2,644 patients were matched with at least one future case as a control.

Gabapentinoid dispensing was associated with nearly twofold increased odds of hip fractures (odds ratio [OR], 1.96, 95 percent confidence interval [CI], 1.66–2.32). The odds remained elevated despite controlling for the exposure-time trend and concomitant use of other central nervous system medications (OR, 1.30, 95 percent CI, 1.07–1.57).

Of note, the odds of hip fractures associated with gabapentinoid dispensing were pronounced in patients with HFRS of at least 5 (OR, 1.75, 95 percent CI, 1.31–2.33) and those with CKD (OR, 2.41, 95 percent CI, 1.65–3.52).

The findings suggest that along with CKD, frailty status may be an important risk factor when considering use of gabapentinoids.