SHM Converge Scientific Abstract ePoster Gallery-Risk of Fall and Fracture With Baclofen in Older Adults

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This real-world cohort study examined whether baclofen increases the risk of falls and fractures in adults age 65 and older compared with two other common muscle relaxants, tizanidine and cyclobenzaprine. Using Geisinger Health System data from 2005–2018, the researchers performed a new-user, active-comparator design and used propensity score-based inverse probability of treatment weighting to balance 56 patient characteristics between groups. They then estimated outcomes with Fine-Gray competing risk regression.<br /><br />Two cohorts were analyzed: baclofen vs tizanidine, and baclofen vs cyclobenzaprine. In Cohort 1, after weighting, baclofen users had a higher risk of fall than tizanidine users (subhazard ratio [SHR] 1.42, 95% CI 1.12–1.79). In Cohort 2, baclofen was not significantly different from cyclobenzaprine for fall risk (SHR 1.15, 95% CI 0.92–1.43). For fractures, baclofen showed no meaningful difference compared with either comparator: versus tizanidine, SHR 0.96 (95% CI 0.77–1.19); versus cyclobenzaprine, SHR 0.84 (95% CI 0.67–1.05).<br /><br />The weighted cohorts were well balanced, with a mean age of 74 years and 59% female in Cohort 1. Musculoskeletal conditions were common, and many patients also used opioids and benzodiazepines. Median follow-up was about 3 months for falls.<br /><br />Overall, baclofen was associated with a greater fall risk than tizanidine but similar fall risk to cyclobenzaprine, while fracture risk was comparable across drugs. The findings may help clinicians weigh benefits and harms when prescribing oral muscle relaxants to older adults.

Asset Subtitle

Yoseob Joseph Hwang

Meta Tag

Author List Alex R. Chang, Daniel J. Brotman, Jung-Im Shin, Lesley Inker, Morgan Grams, Yoseob Joseph Hwang

Category Research

Concept Baclofen

Concept Older Adults

Concept Fall

Concept Fracture

Concept Fall Risk

Concept Future Fracture Risk

Distinguished Non-Finalist

Presenter Organization Johns Hopkins University

Presenting Author Yoseob Joseph Hwang

Track Geriatrics

Keywords

baclofen

falls

fractures

older adults

muscle relaxants

tizanidine

cyclobenzaprine

cohort study

propensity score weighting

Fine-Gray regression

Baclofen

Older Adults

Fall

Fracture

Fall Risk

Future Fracture Risk