IBD: higher risk for spine fractures tied to steroid use

  • Komaki Y & al.
  • J Clin Gastroenterol
  • 18 Apr 2018

  • curated by Miriam Davis, PhD
  • Clinical Essentials
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Takeaway

  • Patients with IBD have high prevalence of osteopenia.
  • A meta-analysis finds that patients with IBD are at increased risk for spine fractures but not overall fractures.
  • Fractures were nonsignificantly more common in steroid users.

Why this matters

  • Strict surveillance and prevention of spine fractures are advised for patients with IBD.

Study design

  • Meta-analysis of 10 studies (n=470,541) that met eligibility criteria after search of PubMed/Medline, Google scholar, Scopus, EMBASE, and Cochrane database.
  • Funding: None disclosed.

Key results

  • No increased risk for overall fractures was seen in patients with IBD vs control patients (OR, 1.08; P=.70).
  • There was no increase in risk for fractures of hip (P=.66), rib (P=1.00), and wrist (P=.97) vs control patients.
  • Increased risk for spine fractures was seen in patients with IBD vs control patients (OR, 2.21; P<.0001>
  • Steroid use was nonsignificantly more common among patients with IBD with fractures vs no fractures (OR, 1.47; P=.057).
  • Osteoporosis was not more common among patients with IBD with fractures vs no fractures (OR, 1.60; P=.14).

Limitations

  • Variable power and outcomes among studies.

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