SynthesisJournal of general internal medicine2016
Effects of Long-Term Low-Molecular-Weight Heparin on Fractures and Bone Density in Non-Pregnant Adults: A Systematic Review With Meta-Analysis.
Synthesis in Journal of general internal medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
27 citing papers in PubMed, 2 syntheses or guidelines pooled it, 73 citations in OpenAlex.
- ASH/ISTH 2026 guidelines for anticoagulant prophylaxis in pediatric patients at risk of venous thromboembolism.Blood advances · 2026Guideline
- Prophylaxis of thromboembolism during therapy with asparaginase in adults with acute lymphoblastic leukaemia.The Cochrane database of systematic reviews · 2020Pooled it
- Impact of Unfractionated Heparin Use on Maternal Bone Mineral Density During Pregnancy: A Retrospective Study Using AI-Assisted Radiographic Analysis.Reproductive sciences (Thousand Oaks, Calif.) · 2026Article
- Long-term enoxaparin use and osteoporosis risk: a real-world cohort study with integrative computational and network toxicology approaches.Journal of translational medicine · 2026Article
- Heparin Anticoagulant Therapy and Its Monitoring.Biomolecules · 2026Review
- Drug-Induced Osteoporosis.Journal of clinical medicine · 2026Review
- The Crucial Role of Tinzaparin in Managing Venous Thromboembolism in the Cancer Population.Journal of clinical medicine · 2025Review
- The Impact of Malignancy on the Risk of Venous Thromboembolism in Pregnant Women: A Systematic Review.Health science reports · 2025Article
- Multifunctional applications and research advances of low-molecular-weight heparin.Frontiers in pharmacology · 2025Review
- Compassionate Use of Osocimab in Preventing Thrombotic Complications Without Incremental Bleeding: A Case Report.TH open : companion journal to thrombosis and haemostasis · 2025Article
- Warfarin and heparin monitoring in antiphospholipid syndrome.Hematology. American Society of Hematology. Education Program · 2024Review
- Management of fracture risk in CKD-traditional and novel approaches.Clinical kidney journal · 2023Review
- A Total of 207 Days of Veno-Venous Extracorporeal Membrane Oxygenation Support for Severe COVID-19 Prior to Successful Lung Transplantation: A Case Report.Journal of personalized medicine · 2022Article
- Not Just Anticoagulation-New and Old Applications of Heparin.Molecules (Basel, Switzerland) · 2022Review
- Impaired bone healing by enoxaparin via inhibiting the differentiation of bone marrow mesenchymal stem cells towards osteoblasts.Journal of bone and mineral metabolism · 2022Article
- Plasma Biomarkers for Clinical Assessment of Bone Mineral Density in Heart Transplanted Patients-A Single-Center Study at Skåne University Hospital in Lund.Transplant international : official journal of the European Society for Organ Transplantation · 2022Article
- Managing Antiphospholipid Syndrome in Children and Adolescents: Current and Future Prospects.Paediatric drugs · 2022Review
- Heparin and Derivatives for Advanced Cell Therapies.International journal of molecular sciences · 2021Review
- Traditional and Non-traditional Risk Factors for Osteoporosis in CKD.Calcified tissue international · 2021Review
- Osteogenic and Angiogenic Properties of Heparin as a System for Delivery of Biomolecules for Bone Bioengineering: a Brief Critical Review.Biochemistry (Moscow) Supplement. Series B, Biomedical chemistry · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAdults who require long-term anticoagulation with low-molecular-weight heparin (LMWH) such as cancer patients or the elderly may be at increased risk of fractures.
objectiveTo determine the effects of LMWH therapy of at least 3 months' duration on fractures and bone mineral density (BMD) in non-pregnant adult populations.
methodsWe systematically reviewed electronic databases (e.g., MEDLINE, EMBASE), conferences and bibliographies until June 2015 and included comparative studies in non-pregnant adult populations that examined the effects of LMWH (≥3 months) on fractures and BMD. We synthesized evidence qualitatively and used random-effects meta-analysis to quantify the effect of LMWH on fractures.
resultsSixteen articles reporting 14 studies were included: 10 clinical trials (n = 4865 participants) and four observational cohort studies (3 prospective, n = 221; 1 retrospective, n = 30). BMD and fractures were secondary outcomes in the majority of trials, while they were primary outcomes in the majority of observational studies. In participants with venous thromboembolism and underlying cardiovascular disease or cancer (5 RCTs, n = 2280), LMWH for 3-6 months did not increase the relative risk of all fractures at 6-12 months compared to unfractionated heparin, oral vitamin K antagonists or placebo [pooled risk ratio (RR) = 0.58, 95 % CI: 0.23-1.43; I(2) = 12.5 %]. No statistically significant increase in the risk of fractures at 6-12 months was found for cancer patients (RR = 1.08, 95 % CI: 0.31-3.75; I(2) = 4.4 %). Based on the data from two prospective cohort studies (n = 166), LMWH for 3-24 months decreased mean BMD by 2.8-4.8 % (depending on the BMD site) compared to mean BMD decreases of 1.2-2.5 % with oral vitamin K antagonists.
conclusionsLMWH for 3-6 months may not increase the risk of fractures, but longer exposure for up to 24 months may adversely affect BMD. Clinicians should consider monitoring BMD in adults on long-term LMWH who are at increased risk of bone loss or fracture.
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