Atopic eczema tied to increased risk for fracture in adults

  • Lowe KE & al.
  • J Allergy Clin Immunol
  • 31 Oct 2019

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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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.