NICE-approved osteoporosis drug linked to AF in women

Alendronate found to raise AF risk by as much as 86 per cent.

A drug commonly used to treat osteoporosis in women could increase the risk of AF and might account for 3 per cent of all cases of the condition, US research suggests.

The use of alendronate is currently recommended by NICE as the first-line treatment in osteoporosis.

Alendronate use was examined in 719 women, aged an average of 75, with confirmed AF and 966 women of a similar age without AF.

Overall, 5 per cent of participants had osteoporosis. When alendronate use was considered, 6.5 per cent of those with AF had taken the drug, compared with 4.1 per cent without a history of AF.

After adjusting for other risk factors, the researchers found that alendronate users were 1.86 times more likely to develop AF than women who had never used the drug.

The researchers suggest that the use of alendronate may cause AF by disrupting the function of regulatory proteins that trigger inflammation and cause decreases in blood calcium and phosphate levels.

But lead researcher Dr Susan Heckbert, from the University of Washington, warned that patients taking alendronate for osteoporosis should not be taken off the drug because of these findings.

'For most patients on alendronate the benefit of fracture prevention from alendronate will outweigh the risk of AF,' she said.

'But the risks of alendronate use need to be weighed up for patients with only a moderate risk of fracture or for patients who have risk factors for AF like diabetes.'

Arch Intern Med 2008; 168: 826-31

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