Bone Fractures in Patients Using Tapentadol or Oxycodone: An Exploratory US Claims Database Study

Figures & data

Figure 1. Patient disposition.

Table 1. Fracture-level characteristics among fractures in tapentadol- and oxycodone-treated patients, during variable length study period.

Characteristics	Tapentadol fractures		Oxycodone fractures		Other fractures
	n = 1105		n = 74,359		n = 129,058
	n (mean)	% (SD)	n (mean)	% (SD)	n (mean)	% (SD)
Age at fracture (mean, SD)	56.7	15.6	54.3	16.5	57.2	16.7
– <65 years, n (%)	837	75.7%	58,401	78.5%	92,635	71.8%
– ≥65 years, n (%)	268	24.3%	15,958	21.5%	36,423	28.2%
Duration of continuous tapentadol treatment prior to fracture (mean, SD)	95.5	247.4
Duration of continuous oxycodone treatment prior to fracture (mean, SD)			34.9	151.7
Opioid days’ supply prior to fracture† (mean, SD)	214.2	357.4	110.9	281.0	141.8	292.3
– Tapentadol days’ supply prior to fracture† (mean, SD)	112.9	260.5	0.5	14.6	1.1	16.6
– Oxycodone days’ supply prior to fracture† (mean, SD)	4.8	38.3	43.8	167.2	22.3	64.4
Total opioid days’ supply during variable length study period (mean, SD)	518.7	629.1	285.5	500.3	250.9	459.9
– Total tapentadol days’ supply during variable-length study period (mean, SD)	240.1	418.9	0.6	19.1	1.3	20.9
– Total oxycodone days’ supply during variable-length study period (mean, SD)	44.8	169.5	121.4	304.4	40.8	117.1
Location of fracture, n (%)
– Skull	34	3.1%	2378	3.2%	6389	5.0%
– Spine and trunk	305	27.6%	16,696	22.5%	23,537	18.2%
– Upper limb	255	23.1%	22,542	30.3%	33,163	25.7%
– Lower limb	484	43.8%	29,959	40.3%	61,344	47.5%
– Multiple locations	27	2.4%	2784	3.7%	4625	3.6%
Medication use prior to fracture, n (%)
– Androgen deprivation therapy and gonadotropin-releasing hormone agonists	2	0.2%	133	0.2%	512	0.4%
– Antidepressants	557	50.4%	28,722	38.6%	60,768	47.1%
– Antiepileptics/anticonvulsants	400	36.2%	16,376	22.0%	38,824	30.1%
– Aromatase inhibitors	1	0.1%	311	0.4%	848	0.7%
– Bisphosphonates	103	9.3%	5062	6.8%	11,956	9.3%
– Calcineurin inhibitors	9	0.8%	542	0.7%	1612	1.2%
– Chemotherapy (ifosfamide, methotrexate and cyclophosphamide)	27	2.4%	1184	1.6%	2853	2.2%
– Glucocorticoids	689	62.4%	34,253	46.1%	87,152	67.5%
– Heparin	20	1.8%	1530	2.1%	518	4.0%
– Medroxyprogesterone acetate	17	1.5%	1193	1.6%	3313	2.6%
– Muscle relaxants	375	33.9%	17,559	23.6%	43,823	34.0%
– Proton pump inhibitors	374	33.8%	19,326	26.0%	46,738	36.2%
– Selective serotonin re-uptake inhibitors	300	27.1%	18,499	24.9%	39,687	30.8%
– Thiazolidinediones	17	1.5%	1584	2.1%	3246	2.5%
Comorbidity prior to fracture, n (%)
– Celiac disease	2	0.2%	163	0.2%	483	0.4%
– Crohn’s disease	10	0.9%	495	0.7%	1202	0.9%
– Depression	229	20.7%	13,749	18.5%	32,904	25.5%
– Diabetes	198	17.9%	12,302	16.5%	27,794	21.5%
– Osteopenia	63	5.7%	2832	3.8%	8524	6.6%
– Osteoporosis	123	11.1%	5099	6.9%	13,000	10.1%
– Ulcerative colitis	11	1.0%	485	0.7%	1485	1.2%

† Measured from the beginning of the preperiod through the date of the first fracture.

SD: Standard deviation.