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COMMENTS & OPINIONS
Association Between SSRI Use and Fractures and the Effect of Confounding by Indication
Gijsbertus Ziere, MD;
Jeanne P. Dieleman, PhD;
Tischa J. M. van der Cammen, MD, PhD;
Bruno H. Ch. Stricker, MB, PhD
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We read with much interest the original investigation by Richards et al.1 They indicate that daily SSRI use in adults 50 years and older was associated with a 2-fold increased risk of clinical fragility fracture after adjustment for potential covariates. These findings are very interesting, and, as the authors state, may have important public health consequences. However, some comments on this article can be made.
Our first concern pertains to the statistical analysis. It is unclear from the article how many fractures were included in the study. Hence, we cannot judge the validity of the statistical model including numerous covariates. Also, it is not mentioned how the authors dealt with dropout and other types of fracture. Furthermore, a Cox-proportional hazards model can be used when the time to event . . . [Full Text of this Article]
AUTHOR INFORMATION
RELATED ARTICLE
Effect of Selective Serotonin Reuptake Inhibitors on the Risk of Fracture
J. Brent Richards, Alexandra Papaioannou, Jonathan D. Adachi, Lawrence Joseph, Heather E. Whitson, Jerilynn C. Prior, David Goltzman, and for the Canadian Multicentre Osteoporosis Study (CaMos) Research Group
Arch Intern Med. 2007;167(2):188-194.
ABSTRACT
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