Abstract
Patients with pemphigus and bullous pemphigoid (BP) have potential risk factors for osteoporosis and/or fractures. To determine whether pemphigus and BP are associated with osteoporosis and fractures in the US, a cross-sectional study of 198,102,435 adults was performed, including 4506 with pemphigus and 8864 with BP from the 2006–2012 National Emergency Department Sample, a 20% sample of emergency care visits throughout the US. Pemphigus was associated with higher odds (multivariate logistic regression; adjusted odds ratio [95% confidence intervals]) of osteopenia (2.20 [1.59–3.05]), osteoporosis (2.54 [2.16–2.98]), osteomalacia (29.70 [4.05–217.83]), and pathological fractures (2.04 [1.42–2.91]). BP was associated with osteoporosis (1.55 [1.39–1.73]) and pathological fractures (1.52 [1.22–1.88]). When compared to BP, pemphigus was associated with higher odds of osteopenia (1.59 [1.06–2.41]), osteoporosis (1.38 [1.18–1.63]), and fractures (1.26 [1.04–1.53]), particularly of the ulna and radius (3.17 [1.23–8.17]). Patients with pemphigus or BP as well as long-term systemic corticosteroid use had highest odds of osteoporosis and fractures. No data were available on treatments for pemphigus or BP. Pemphigus and BP were associated with osteopenia, osteoporosis, and pathologic fractures. Patients with PEM and BP may benefit from increased screening for osteoporosis and interventions to prevent fractures.
Original language | English (US) |
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Pages (from-to) | 263-271 |
Number of pages | 9 |
Journal | Archives of Dermatological Research |
Volume | 312 |
Issue number | 4 |
DOIs | |
State | Published - May 1 2020 |
Funding
This publication was made possible with support from the Agency for Healthcare Research and Quality (AHRQ) (JIS), NIH K12 HS023011 (JIS), the Dermatology Foundation (JIS), and NIH T32 AR060710 (RC). Design and conduct of the study? No. Collection, management, analysis and interpretation of data? No. Preparation, review, or approval of the manuscript? No. Decision to submit the manuscript for publication? No.
Keywords
- Autoimmune
- Bullous
- Burden
- Comorbidities
- Cost of care
- Emergency care
- Hospitalization
- Length of stay
- Osteomalacia
- Osteopenia
- Osteoporosis
- Pemphigoid
- Pemphigus
- Urgent care
ASJC Scopus subject areas
- Dermatology