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Corticosteroid therapy is integral to the treatment of polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) and a new retrospective cohort study from the UK shows that PMR and GCA have similar, increased risk of fractures.
Analysis of the UK-based Clinical Practice Research Datalink compared incident cases of PMR (n=12,136) and GCA (n=2673) with four age-, sex- and practice-matched controls to calculate fracture rates per 10,000 person-years
The incidence rate of fracture was 148.05 (95% CI 141.16–155.28) in PMR and 147.15 (132.91–162.91) in GCA per 10,000 person-years.
Risk of fracture was increased by 63% in PMR (adjusted hazard ratio 1.63, 95% CI 1.54–1.73) and 67% in GCA (1.67, 1.49–1.88) compared to the control populations.
A minority(13%) of glucocorticoid-treated cases were prescribed bisphosphonates.
The authors called for further research to identify whether lower glucocorticoid starting doses and/or aggressive dose reduction reduces fracture risk.