Fracture Risk in Patients with Myasthenia Gravis: A Population-Based Cohort Study

Author:

Kassardjian Charles12,Widdifield Jessica345,Paterson J. Michael45,Kopp Alexander5,Nagamuthu Chenthila5,Barnett Carolina6,Tu Karen7,Breiner Ari8

Affiliation:

1. Department of Medicine, Division of Neurology, St. Michael’s Hospital, Toronto, ON, Canada

2. Neurology Quality and Innovation Lab, University of Toronto, Toronto, ON, Canada

3. Holland Bone & Joint Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada

4. Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, ON, Canada

5. ICES, Toronto, ON, Canada

6. Ellen and Martin Prosserman Centre for Neuromuscular Diseases, Division of Neurology, Department of Medicine, University Health Network, University of Toronto, Toronto, ON, Canada

7. Department of Community and Family Medicine, North York General Hospital, University Health Network, Toronto, ON, Canada

8. Department of Medicine, Division of Neurology, The Ottawa Hospital, and Ottawa Hospital Research Institute, Ottawa, ON, Canada

Abstract

Background: Prednisone is a common treatment for myasthenia gravis (MG), and osteoporosis is a known potential risk of chronic prednisone therapy. Objective: Our aim was to evaluate the risk of serious fractures in a population-based cohort of MG patients. Methods: An inception cohort of patients with MG was identified from administrative health data in Ontario, Canada between April 1, 2002 and December 31, 2015. For each MG patient, we matched 4 general population comparators based on age, sex, and region of residence. Fractures were identified through emergency department and hospitalization data. Crude overall rates and sex-specific rates of fractures were calculated for the MG and comparator groups, as well as rates of specific fractures. Adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox regression. Results: Among 3,823 incident MG patients (followed for a mean of 5 years), 188 (4.9%) experienced a fracture compared with 741 (4.8%) fractures amongst 15,292 matched comparators. Crude fracture rates were not different between the MG cohort and matched comparators (8.71 vs. 7.98 per 1000 patient years), overall and in men and women separately. After controlling for multiple covariates, MG patients had a significantly lower risk of fracture than comparators (HR 0.74, 95% CI 0.63–0.88). Conclusions: In this large, population-based cohort of incident MG patients, MG patients were at lower risk of a major fracture than comparators. The reasons for this finding are unclear but may highlight the importance osteoporosis prevention.

Publisher

IOS Press

Subject

Clinical Neurology,Neurology

Reference24 articles.

1. International consensus guidance for management of myasthenia gravis: Executive summary;Sanders;Neurology,2016

2. Low dose long-term corticosteroid therapy in rheumatoid arthritis: An analysis of serious adverse events;Saag;The American Journal of Medicine,1994

3. Population-based assessment of adverse events associated with long-term glucocorticoid use;Curtis;Arthritis Rheum,2006

4. Myasthenia gravis: A changing pattern of incidence;Casetta;J Neurol,2010

5. Unusual case of recurrent falls Myasthenia gravis in an elderly patient;Alaama;Can Fam Physician,2012

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3