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 20 May 2018

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News

Inflammatory bowel disease and the risk of fracture

Patients with inflammatory bowel disease have a higher risk of fracture due to both disease activity and use of oral corticosteroids, find physicians in the latest issue of Gastroenterology.

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Patients with inflammatory bowel disease (IBD) have reduced bone mass. However, it is unclear whether these patients also have an increased risk of fracture.

In this study, physicians from England and the Netherlands examined the risk of fracture and its predictors in patients with IBD.

The physicians recruited 231,778 fracture cases, and 231,778 age- and sex-matched controls.

They assessed any history of IBD from medical records.
Only 13% of patients who had already sustained a fracture were on antifracture treatment.
Gastroenterology

The team determined that the prevalence of IBD was 156 and 282 per 100,000 for Crohn’s disease (CD) and ulcerative colitis (UC), respectively.

They found that patients with IBD had an increased risk of vertebral fracture (OR 1.72) and hip fracture (OR 1.59).

Furthermore, the risk of hip fracture was greater in patients with CD (OR 1.86), compared with UC (OR 1.40).

The team established that disease severity predicted fracture, even after adjusting for corticosteroid use (OR 1.46).

They also found that only 13% of patients with IBD who had already sustained a fracture were on any form of antifracture treatment.

Dr Tjeerd-Pieter Van Staa's team concluded, "Patients with IBD have a higher risk of fracture due to both disease activity and use of oral corticosteroids".

"However, few of these patients are receiving optimal bone-sparing therapy, highlighting the importance of increasing awareness of osteoporosis in those managing these patients".

Gastroenterol 2003; 125(6): 1591-8
10 December 2003

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