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Risk of fractures in individuals with eosinophilic esophagitis: nationwide population-based cohort study.
Garber, John J; Roelstraete, Bjorn; Lochhead, Paul J; Uchida, Amiko M; Michaëlsson, Karl; Olén, Ola; Ludvigsson, Jonas F.
Afiliação
  • Garber JJ; Gastrointestinal Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
  • Roelstraete B; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
  • Lochhead PJ; Gastrointestinal Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
  • Uchida AM; Clinical and Translational Epidemiology Unit, Mongan Institute, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
  • Michaëlsson K; Gastrointestinal Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
  • Olén O; Division of Gastroenterology, Hepatology and Nutrition, University of Utah School of Medicine, Salt Lake City, UT, USA.
  • Ludvigsson JF; Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
Esophagus ; 19(4): 542-553, 2022 10.
Article em En | MEDLINE | ID: mdl-35764719
BACKGROUND AND AIMS: Eosinophilic esophagitis (EoE) is an emerging, chronic immune-mediated disease for which swallowed topical steroids and proton pump inhibitors (PPIs) represent first-line treatments. Immune-mediated diseases, steroids, and PPI use have been linked to osteoporosis. We assessed the risk of fractures in patients with EoE and determined whether the most commonly used treatments for EoE were associated with increased fracture risk. METHODS: We followed a nationwide cohort of 1263 individuals in Sweden with biopsy-verified EoE diagnosed between 2005 and 2016 for first-time fracture of any type. Age- and sex-matched reference individuals were retrieved from the Total Population Register (n = 5164). We estimated hazard ratios (HRs) for fracture in relation to EoE diagnosis, steroid exposure, and PPI use. In a separate analysis, we compared fracture risk among individuals with EoE to their siblings (n = 1394). RESULTS: During 4521 person-years of follow-up, 69 individuals with EoE experienced a first-time fracture (15.3/1000 person-years) compared with 234 reference individuals (12.6/1000 person-years). After adjusting for age, sex, birth year, and county of residence, EoE was not associated with a statistically significantly increased risk of fractures (HR = 1.2, 95% CI = 0.9-1.6). Among EoE individuals, exposure to PPIs and swallowed steroids did not modify the risk of fracture (p for heterogeneity 0.20 and 0.07 respectively). There was no increased risk of fractures in EoE compared to EoE-free siblings. CONCLUSION: The risk of fracture in EoE was not statistically significantly elevated compared to non-EoE reference individuals. Fracture risk in EoE was not modified by PPIs or steroid use.
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Texto completo: 1 Coleções: 01-internacional Temas: Geral Base de dados: MEDLINE Assunto principal: Esofagite Eosinofílica Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: Esophagus Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Temas: Geral Base de dados: MEDLINE Assunto principal: Esofagite Eosinofílica Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: Esophagus Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Estados Unidos