IBD carries increased risk of fractures in Asians

Individuals with newly diagnosed inflammatory bowel disease (IBD), particularly Crohn’s disease (CD), are at heightened risk of fractures regardless of corticosteroid exposure, as reported in a study from Korea.

Using data from the Korean National Health Insurance claims database, the study included 18,228 patients with newly diagnosed IBD (64.1 percent male, 65.9 percent with ulcerative colitis [UC]). Researchers evaluated the risk of vertebral and hip fractures in the IBD group and compared it against that of 186,871 sex-matched control population.

Over a median follow-up of 4.5 years, the incidence rate of vertebral and hip fractures in patients with IBD were 2.88 per 1,000 person-years. The corresponding incidence rate ratio (IRR) was 1.24 (95 percent confidence interval [CI], 1.08–1.42).

In the IBD group, the cumulative risk of vertebral and hip fractures was 0.6 percent at 2 years, 1.4 percent at 5 years, and 1.9 percent at 7 years after diagnosis. These estimates were much higher than those in matched controls (p=0.002).

Corticosteroid use contributed to a further increase in the risk of fractures in the IBD group (IRR, 1.37, 95 percent CI, 1.13–1.65).

When looking at subtypes, the risk increase in fractures was more pronounced among patients with CD (IRR, 1.56, 95 percent CI, 1.19–2.04) than among matched controls, and this risk remained elevated for CD patients without corticosteroid exposure (IRR, 1.62, 95 percent CI, 1.12–2.34).

Finally, the risk of fracture associated with IBD rose with age and was especially pronounced in women and individuals with comorbidities.