In Reply Dr Sugiyama suggested some possible mechanisms for our results and directions for further research. We agree that it is worth investigating whether dabigatran could reduce the risk of falls in future studies. We were unable to look in detail at hip and vertebral fractures separately because of the small number of events; even the composite outcome was rare (<1.0 per 100 person-years). Additional studies that examine the risk of falls, as well as fall-related and fall-unrelated fractures, are therefore warranted to evaluate the possible roles of dabigatran and warfarin in association with fracture risk, especially among patients receiving short-term treatment (<1 year).
Lau WCY, Wong ICK, Chan EW. Osteoporotic Fractures Associated With Dabigatran vs Warfarin—Reply. JAMA. 2017;318(1):91. doi:10.1001/jama.2017.6912