|
|||||
|
|
Fracture rate in patients with myasthenia gravis: the general practice research database |
|
| Authors: | S Pouwels A de Boer M K Javaid D Hilton-Jones J Verschuuren C Cooper H G Leufkens F de Vries |
| Institution: | 1. Utrecht Institute for Pharmaceutical Sciences, Universiteit Utrecht, Utrecht, the Netherlands 2. Oxford NIHR Musculoskeletal Biomedical Research Unit, Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK 3. Department of Clinical Neurology, University of Oxford, Oxford, UK 4. Department of Neurology, Leiden University Medical Centre, Leiden, the Netherlands 5. MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK 6. Department of Clinical Pharmacy & Toxicology, Maastricht University Medical Centre, Maastricht, the Netherlands 7. Universiteitsweg 99, 3584 CG, Utrecht, the Netherlands |
| Abstract: | SummaryThe aim of this study was to evaluate fracture risk after onset of myasthenia gravis using the UK General Practice Research Database. Overall fracture risk is not statistically increased compared with age- and gender-matched controls irrespective of glucocorticoid use, but was increased in those using antidepressants, anxiolytics or anticonvulsants.IntroductionMyasthenia gravis (MG) is a neuromuscular disease which has been associated with an increased falls risk and glucocorticoid-induced osteoporosis, recognized determinants of increased fracture risk. The aim of this study was to evaluate the risk of fracture after onset of MG.MethodsWe conducted a retrospective cohort study using the UK General Practice Research Database (1987–2009). Each MG patient was matched by age, sex, calendar time and practice to up to six patients without a history of MG and we identified all fractures and those associated with osteoporosis.ResultsCompared to the control cohort, there was no statistically significant increased risk observed in patients with MG for any fracture (adjusted hazard ratio AHR] 1.11; 95 % confidence interval CI], 0.84–1.47) or osteoporotic fractures (AHR 0.98 95 % CI 0.67–1.41]). Further, use of oral glucocorticoids up to a cumulative dose exceeding 5 g prednisolone equivalents did not increase risk of osteoporotic fracture (AHR 0.99 95 % CI, 0.31–3.14]) compared with MG patients without glucocorticoid exposure. However, fracture risk was higher in patients with MG prescribed antidepressants (AHR 3.27 95 % CI, 1.63–6.55]), anxiolytics (AHR 2.18 95 % CI, 1.04–4.57]) and anticonvulsants (AHR 6.88 95 % CI, 2.91–16.27]).ConclusionOverall risk of fracture in patients with MG is not statistically increased compared with age- and gender-matched controls irrespective of glucocorticoid use but was increased in those using antidepressants, anxiolytics or anticonvulsants. These findings have implications in strategies preserving bone health in patients with MG. |
| Keywords: | |
| 本文献已被 SpringerLink 等数据库收录！ | |