Eczema and fracture risk; avoiding oral corticosteroids may not be enough

Published: September 24, 2021

Previous studies have suggested that adults with (atopic) eczema have increased fracture risk, especially those with severe eczema. It was assumed that oral corticosteroids, which may be prescribed to manage eczema and are well known to cause osteoporosis, may explain the link between eczema and fracture.

A recent study, published in The Journal of Allergy and Clinical Immunology: In Practice by Matthewman et al, suggests that the increased fracture risk in people with eczema may not be explained by oral corticosteroids. The authors conducted a cohort study using English primary care and hospital admissions records from 1998-2016 identifying over half a million people with eczema. Oral corticosteroid prescribing was captured in detail, and the authors found that adjusting analyses for different definitions of oral corticosteroid use made little difference to the finding that people with eczema have an increased fracture risk. This suggests that eczema drives the risk of fractures through other mechanisms, for example chronic inflammation, diet, physical activity, or sleep issues. The authors recommended that future work focus on identifying what puts people with eczema at an increased risk of fractures. Clinicians and people with eczema should be aware that, even if oral corticosteroids can be avoided, those with severe eczema may still be at increased risk of  fracture.

The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.

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