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Fragility fractures and prescriptions of medications for osteoporosis in patients with polymyalgia rheumatica: results from the PMR Cohort Study

Paskins, Zoe; Sokhal, Balamrit Singh; Hider, Samantha L; Mallen, Christian D; Muller, Sara

Fragility fractures and prescriptions of medications for osteoporosis in patients with polymyalgia rheumatica: results from the PMR Cohort Study Thumbnail


Authors

Balamrit Singh Sokhal



Abstract

OBJECTIVES: PMR is a common indication for long-term glucocorticoid treatment, leading to an increased risk of osteoporosis and fragility fractures. Guidelines recommend calcium and vitamin D for all patients, in addition to anti-resorptive agents for high-risk patients. The aim of this study was to investigate falls and fragility fracture history and the use of medications for osteoporosis in a PMR cohort. METHODS: Six hundred and fifty-two people with incident PMR responded to a postal survey. Self-reported data on falls, fragility fracture history and medication were collected at baseline. Follow-up data on fragility fractures (hip, wrist and spine) and falls were collected at 12 and 24?months. Logistic regression was used to assess the association between baseline characteristics and fractures. RESULTS: Fewer than 50% of respondents received osteoporosis treatments, including supplements. One hundred and twelve (17.2%) participants reported a fragility fracture at baseline, 72 participants reported a fracture at 12?months, and 62 reported a fracture at 24?months. Baseline history of falls was most strongly associated with fracture at 12 (odds ratio 2.35; 95% CI: 1.35, 4.12) and 24?months (1.91; 1.05, 3.49) when unadjusted for previous fractures. CONCLUSION: Fracture reporting is common in people with PMR. To improve fracture prevention, falls assessment and interventions need to be considered. A history of falls could help to inform prescribing decisions around medications for osteoporosis. Future research should consider both pharmacological and non-pharmacological approaches to reducing fracture risk.

Journal Article Type Article
Acceptance Date Nov 18, 2021
Online Publication Date Nov 27, 2021
Publication Date Nov 27, 2021
Publicly Available Date May 30, 2023
Journal Rheumatology Advances in Practice
Print ISSN 2514-1775
Publisher Oxford University Press
Article Number rkab094
DOI https://doi.org/10.1093/rap/rkab094
Publisher URL https://academic.oup.com/rheumap/article/5/3/rkab094/6445004

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