Myasthenia Gravis and risk of fracture: the general practice research database

Abstract

Event Abstract Back to Event Myasthenia Gravis and risk of fracture: the general practice research database A Lalmohamed1*, MT Bazelier1, S Pouwels1, MK Javaid2, C Cooper3, D Hilton-Jones4, J Verschuuren5, TP Van Staa6 and F De Vries7 1 Utrecht University, Division of Pharmacoepidemiology and Clinical Pharmacology 2 University of Oxford, Institute of Musculoskeletal Sciences, United Kingdom 3 University of Southampton, MRC Lifecourse Epidemiology Unit, United Kingdom 4 University of Oxford, Department of Clinical Neurology, United Kingdom 5 Leiden University Medical Centre, Department of Neurology 6 Medinices and Healthcare products Regulatory Agency, General Practice Research Database, United Kingdom 7 Medinices and Healthcare products Regulatory Agency, General Practice Research Database, United Kingdom Background: Myasthenia Gravis (MG) is a neuromuscular disease with symptoms of muscle weakness and fatiguability. MG has been associated with falling and glucocorticoid induced osteoporosis. Aim of this study was to evaluate the risk of fracture after onset of MG. {BR}Methods: We conducted a retrospective cohort study (1987-2009, n=7,458) using the UK General Practice Research Database. Each MG patient was matched by age, sex, calendar time, and practice to up to 6 patients without a history of MG. {BR}Results: No increased fracture risk was observed in patients with incident MG (adjusted hazard ratio "AHR" 1.11; 95% confidence interval "CI", 0.84 - 1.47). Use of oral glucocorticoids up to a cumulative dose exceeding 5 grams prednisolone equivalents did not further alter fracture risk (AHR 1.15 [95% CI, 0.40 - 3.30]). Fracture risk was doubled for recent use of antidepressants (AHR 1.81 [95% CI, 1.07 - 3.06]), anxiolytics/sedatives (AHR 1.97 [95% CI, 1.14 - 3.41]) and five-fold increased among recent users of anticonvulsants (AHR 4.98 [95% CI, 2.68 - 9.26]). {BR}Conclusion: MG itself was not associated with increased fracture risk, except for patients using antidepressants, anxiolytics/sedatives or anticonvulstants. The use of (very high dosages of) oral glucocorticoids among MG patients did not alter fracture risk, for which the underlying mechanism remains unclear. Keywords: Bones, Bone Research Conference: 2011 joint meeting of the Bone Research Society & the British Orthopaedic Research Society, Cambridge, United Kingdom, 27 Jun - 29 Jun, 2011. Presentation Type: Poster Topic: Abstracts Citation: Lalmohamed A, Bazelier M, Pouwels S, Javaid M, Cooper C, Hilton-Jones D, Verschuuren J, Van Staa T and De Vries F (2011). Myasthenia Gravis and risk of fracture: the general practice research database. Front. Endocrinol. Conference Abstract: 2011 joint meeting of the Bone Research Society & the British Orthopaedic Research Society. doi: 10.3389/conf.fendo.2011.02.00038 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 30 Sep 2011; Published Online: 30 Sep 2011. * Correspondence: Mr. A Lalmohamed, Utrecht University, Division of Pharmacoepidemiology and Clinical Pharmacology, a.lalmohamed@uu.nl Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers A Lalmohamed MT Bazelier S Pouwels MK Javaid C Cooper D Hilton-Jones J Verschuuren TP Van Staa F De Vries Google A Lalmohamed MT Bazelier S Pouwels MK Javaid C Cooper D Hilton-Jones J Verschuuren TP Van Staa F De Vries Google Scholar A Lalmohamed MT Bazelier S Pouwels MK Javaid C Cooper D Hilton-Jones J Verschuuren TP Van Staa F De Vries PubMed A Lalmohamed MT Bazelier S Pouwels MK Javaid C Cooper D Hilton-Jones J Verschuuren TP Van Staa F De Vries Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. Please enable Javascript in your browser settings in order to see all the content on this page.