Bisphosphonates are widely used for the prevention and treatment of osteoporosis. Nonsteroidal anti-inflammatory drugs (NSAIDs) are also widely used among the older population group at high risk of fractures. NSAIDs have been shown to impact on bone turnover, and a recent reanalysis of a clinical trial of clodronate found that NSAID use at baseline abrogated any effect of clodronate on either bone density (BMD) or fracture risk. To determine whether NSAIDs influence the efficacy of other bisphosphonates, we have reanalyzed our 6-year randomized controlled trial of zoledronate in 2000 osteopenic postmenopausal women. NSAID use was reported at baseline in 38% of the cohort and anytime use was reported by 65%. The evolution of the zoledronate effects on BMD were almost identical whether or not women were using NSAIDs at baseline and were significant in both subgroups at all BMD sites (p < 0.0001). The significant reduction in the risk of fracture in those allocated to zoledronate (p < 0.0001) showed no interaction with baseline use of NSAIDs (p = 0.33) nor with NSAID use at any time during the study (p = 0.28). The odds of fracture were significantly reduced in both NSAID users and nonusers. We conclude that the present analysis provides no support for the suggestion that NSAIDs interfere with the efficacy of potent bisphosphonates in terms of their effects on bone density or fracture. © 2023 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).

中文翻译：

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使用非甾体抗炎药对唑来膦酸的疗效没有影响：骨质减少老年女性随机试验的事后分析

双膦酸盐广泛用于预防和治疗骨质疏松症。非甾体类抗炎药（NSAID）也广泛用于骨折高风险的老年人群。NSAID 已被证明会影响骨转换，最近对氯膦酸盐临床试验的重新分析发现，基线使用 NSAID 消除了氯膦酸盐对骨密度 (BMD) 或骨折风险的任何影响。为了确定 NSAID 是否影响其他双膦酸盐的疗效，我们重新分析了对 2000 名骨质疏松绝经后妇女进行的唑来膦酸盐的 6 年随机对照试验。队列中 38% 的人报告在基线时使用 NSAID，65% 的人报告随时使用。无论女性是否在基线时使用 NSAID，唑来膦酸盐对 BMD 影响的演变几乎相同，并且在所有 BMD 部位的两个亚组中均显着 ( p  < 0.0001)。分配给唑来膦酸盐的患者骨折风险显着降低（p  < 0.0001），这与基线使用 NSAID 没有相互作用（p  = 0.33），也与研究期间任何时间使用 NSAID 没有相互作用（p  = 0.28）。非甾体抗炎药使用者和非使用者的骨折几率均显着降低。我们的结论是，目前的分析并没有支持以下建议：非甾体抗炎药会干扰强效双膦酸盐对骨密度或骨折的影响。© 2023 作者。《Journal of Bone and Mineral Research》由 Wiley periodicals LLC 代表美国骨与矿物研究学会 (ASBMR) 出版。