Levothyroxine dose and risk of fracture in geriatric patients

January 01, 0001

Levothyroxine dose and risk of fracture in geriatric patients

These Canadian researchers sought to characterize the risk of fractures in geriatric patients due to levothyroxine dose through a nested case-control study using a population based health databases. They looked at patients in the database over aged 70 who were prescribed levothyroxine. They defined cases as patients hospitalized due to a fracture. These were matched with up to five controls from within the cohort who were fracture free.

The researchers found: "Of 213,511 prevalent levothyroxine users identified, 22,236 (10.4%) experienced a fracture over a mean 3.8 years of follow-up, 18,108 (88%) of whom were women. Compared with remote levothyroxine use, current use was associated with a significantly higher risk of fracture (adjusted odds ratio 1.88), despite adjustment for numerous risk factors. Among current users, high and medium cumulative doses (>0.093 mg/day and 0.044-0.093 mg/day) were associated with a significantly increased risk of fracture compared with low cumulative doses (<0.044 mg/day): 3.45 and 2.62, respectively."

The researchers concluded: "Among adults aged 70 or more, current levothyroxine treatment was associated with a significantly increased risk of fracture, with a strong dose-response relation. Ongoing monitoring of levothyroxine dose is important to avoid overtreatment in this population."

This study suggests levothyroxine is associated with a dose dependent fracture risk in older patients.

For the full abstract, click here.

BMJ 342:d2238, 28 April 2011 © 2011 BMJ Publishing Group Ltd.
Levothyroxine dose and risk of fractures in older adults: nested case-control study. Marci R Turner, Ximena Camacho, Hadas D Fischer, et al. Correspondence to L L Lipscombe: [email protected]

Category: M. Musculoskeletal, T. Endocrine/Metabolic/Nutritional. Keywords: levothyroxine, fracture, hip, dose, geriatric, nested case-control, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 12 August 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.

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