Takeaway
- The risk for fracture was higher in patients with atopic eczema, particularly in those with severe eczema.
- The increased risk was more pronounced for major osteoporotic fractures, including spinal, pelvic and hip fractures.
Why this matters
- Findings suggest that patients with severe atopic eczema may benefit from targeted bone density testing and strategies for the prevention of fracture.
Study design
- Population-based study of adults (≥18 years old) with atopic eczema (n=526,808) matched with up to 5 individuals without eczema (n=2,569,030) using data from the UK primary care and hospital admissions.
- Stratified Cox regression used to estimate HRs comparing fracture risk in adults with eczema vs those without eczema.
- Funding: Health Data Research UK.
Key results
- Patients with eczema had an increased risk for fractures including:
- hip fractures (HR, 1.10; 99% CI, 1.06-1.14),
- pelvic fractures (HR, 1.10; 99% CI, 1.02-1.19),
- spinal fractures (HR, 1.18; 99% CI, 1.10-1.27) and
- wrist fractures (HR, 1.07; 99% CI, 1.03-1.11).
- Risk for fracture increased with increasing severity, with the strongest associations in patients with severe eczema for:
- spinal fractures (HR, 2.09; 99% CI, 1.66-2.65),
- pelvic fractures (HR, 1.66; 99% CI, 1.26-2.20) and
- hip fractures (HR, 1.50; 99% CI, 1.30-1.74).
- Association between atopic eczema and fracture was slightly attenuated after adjustment for body mass index, smoking, harmful alcohol use and high-dose oral glucocorticoid use.
Limitations
- Data collected as part of routine care rather than specifically for research.
- Risk of potential confounding.
References
References