Prescrire international
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Prescrire international · Apr 2011
Bisphosphonates and atrial fibrillation: clinical trial data suggest possible link.
In 2007, an article describing an American placebo-controlled clinical trial of yearly zoledronic acid infusion at a dose of 5 mg mentioned a statistically significant excess of severe atrial fibrillation in postmenopausal women. Bisphosphonates had not previously been linked to this adverse effect. Several meta-analyses of clinical trials have been published, but they covered only a small number of the hundreds of comparative trials evaluating bisphosphonates, few of which mentioned atrial fibrillation. ⋯ No cardiac adverse effects were mentioned in a report analysing two trials in patients with Paget's disease. Pending the publication of more data, the potential risk of severe atrial fibrillation in some patients treated with bisphosphonates should be taken into account. There is no evidence of an increased risk with a specific bisphosphonate, route of administration, patient subpopulation, or treatment duration.