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Journal article

Use and risk of side effects of antiresorptive medication in people with intellectual disabilities

Abstract:
Background:
Recent studies show that adults with intellectual disabilities (ID) have high incidence of major osteoporotic fracture, especially hip fracture. In those ≥ 50 years, women and men with ID have an approximately two and four times higher rate of hip fracture than women and men without ID. Increased awareness of osteoporotic fracture risk in ID may lead to wider use of antiresorptive drugs (bisphosphonates and denosumab) in this population. We aimed to compare, between people with and without ID, the incidence of 1) major side effects, namely medication related osteoporosis of the jaw (ONJ) and oesophagitis; 2) oral pathology, which can be a risk factor for ONJ.

Methods:
Exploratory study investigating safety of first line osteoporosis medication within the population of a previous study comparing fracture incidence in people with and without ID in the GOLD database of the Clinical Practice Research Datalink 1998–2017.

Results:
The percentage of people on antiresorptive drugs was identical in the ID and non ID group (1.4%). The number of individuals who developed ONJ and oesophagitis during the study was too low to allow an accurate estimate of incidence of the events and a comparison between the two groups. The incidence of any oral pathology was 119.31 vs 64.68/10000 person year in the ID vs non ID group.

Conclusions:
Medication related ONJ and oesophagitis are rare in people with and without ID. There is no reason based on our findings to use antiresorptives differently in people with ID as in the rest of the population. However, the potential for side effects of antiresorptives will inherently increase with wider use of these drugs. Given the higher incidence of oral pathology in people with ID, which could put them at higher risk of ONJ, precautions should be taken to prevent this complication by attention to oral health.
 
Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.3310/nihropenres.13352.1

Authors

More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Psychiatry
Role:
Author
ORCID:
0000-0001-8177-8778
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Primary Care Health Sciences
Role:
Author
ORCID:
0000-0002-0946-742X
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Primary Care Health Sciences
Role:
Author


More from this funder
Funder identifier:
https://ror.org/05b6cq467
Grant:
6226-9461
More from this funder
Funder identifier:
https://ror.org/0187kwz08
Grant:
PB-PG-1216-20017


Publisher:
NIHR
Journal:
NIHR Open Research More from this journal
Volume:
2
Article number:
61
Place of publication:
England
Publication date:
2022-12-13
Acceptance date:
2023-10-10
DOI:
ISSN:
2633-4402
Pmid:
37881308


Language:
English
Keywords:
Pubs id:
1316825
Local pid:
pubs:1316825
Deposit date:
2025-01-23
ARK identifier:

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