SRS183 - Calcium channel blockers and bone aealth: a systematic review of preclinical and clinical evidence

Abstract Background Calcium channel blockers (CCBs) are widely prescribed for older adults at risk of osteoporotic fractures. Despite preclinical data suggesting CCB-mediated effects on bone remodelling, clinical findings on bone mineral density (BMD) risk of bias was assessed with appropriate tools (SYRCLE, RoB 2, ROBINS-I). A narrative synthesis was performed. Results 34 studies were included (17 preclinical; 17 clinical). Among clinical studies, 4/17 reported reduced BMD with CCBs; fracture risk increased in 4, decreased in 4, 1 study additionally reported a protective association with osteoporosis. Preclinical findings across 655 animals were mixed for BMD, calcium, PTH, ALP, these mechanisms remain hypothesis-generating. Standardised preclinical endpoints & large, well-adjusted prospective cohorts stratified by dihydropyridine versus non-dihydropyridine agents, dose, & duration are needed to clarify skeletal effects.