Association of pemphigus and pemphigoid with osteoporosis and pathological fractures

AbstractPatients 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 systemi c 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...
Source: Archives of Dermatological Research - Category: Dermatology Source Type: research

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Publication date: Available online 24 September 2020Source: The Lancet Respiratory MedicineAuthor(s): Anna Schultze, Alex J Walker, Brian MacKenna, Caroline E Morton, Krishnan Bhaskaran, Jeremy P Brown, Christopher T Rentsch, Elizabeth Williamson, Henry Drysdale, Richard Croker, Seb Bacon, William Hulme, Chris Bates, Helen J Curtis, Amir Mehrkar, David Evans, Peter Inglesby, Jonathan Cockburn, Helen I McDonald, Laurie Tomlinson
Source: The Lancet Respiratory Medicine - Category: Respiratory Medicine Source Type: research
Publication date: Available online 24 September 2020Source: The Lancet Respiratory MedicineAuthor(s): Dave Singh, David M G Halpin
Source: The Lancet Respiratory Medicine - Category: Respiratory Medicine Source Type: research
Objective: Fracture risk increases with age, but few studies focus on persons ≥80 years. In the ACTIVE trial, treatment with abaloparatide for 18 months reduced osteoporotic fracture risk and increased bone mineral density. These effects were maintained with 24 months alendronate treatment in ACTIVExtend. We postulated that similar improvements in bone mineral density and safety would be demonstrated in women ≥80 years. Methods: Post hoc analyses of bone mineral density and fracture incidence in women with osteoporosis at high risk of fracture ≥80 years from ACTIVExtend. Results: In total, 56 women aged &g...
Source: Menopause - Category: OBGYN Tags: Original Studies Source Type: research
Selective estrogen receptor modulators (SERMs) are an increasingly important therapeutic modality that are used by clinicians on a daily basis. Unfortunately, clinicians have a limited understanding regarding the underlying mechanism(s) of how SERMs function and their increasingly useful role in the treatment of estrogen-responsive target tissues such as the breast, bone, vagina, uterine endometrium, and brain. This review will provide a basic understanding of our current knowledge of SERM pharmacodynamics and will highlight the clinical applications of Food and Drug Administration–approved SERMs in the treatment of ...
Source: Menopause - Category: OBGYN Tags: Clinical Corner: Invited Review Source Type: research
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Source: SafetyLit - Category: International Medicine & Public Health Tags: Age: Elder Adults Source Type: news
Conditions:   Osteoporotic Fractures;   Osteoporosis;   Osteoporosis Risk Intervention:   Behavioral: Support on dentification and treatment of patients with high risk of osteoporotic fractures Sponsors:   Helena Salminen;   Stockholm County Council, Sweden Active, not recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Condition:   Ulcerative Colitis Intervention:   Drug: Corticosteroid Sponsor:   Tampere University Hospital Completed
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Background: Patients with pemphigus (PEM) and bullous pemphigoid (BP) have risk factors for decreased bone mineral density including long-term use of systemic corticosteroids and chronic inflammation. Few studies examined the associations of PEM and BP with osteoporosis and fractures. We sought to determine whether PEM and BP are associated with osteoporosis and fracture in the US population.
Source: Journal of the American Academy of Dermatology - Category: Dermatology Source Type: research
Conclusions The clinical trials discussed here, which include several trials investigating novel therapeutic targets, demonstrate that translational research in pemphigus and pemphigoid is a fast-growing field. We thus expect that several novel treatments will be shortly available for the treatment of pemphigus and pemphigoid patients. Given the high, and thus far unmet, medical need in this field (110), this is highly encouraging and will hopefully improve the quality of life of the affected patients. In addition to the compounds and targets described here, several new targets have been recently identified in preclinical...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
We describe and discuss novel therapeutic strategies that directly interfere with the production and regulation of pathogenic autoantibodies (rituximab), their catabolism (intravenous immunoglobulins), and their presence in the circulation and extravascular tissues such as the skin (immunoadsorption), leading to a significant amelioration of disease. Moreover, we show that these novel therapies have pleiotropic effects on various proinflammatory cells and cytokines. Recent studies in bullous pemphigoid suggest that targeting of immunoglobulin E autoantibodies (omalizumab) may be also beneficial. In summary, the introductio...
Source: Drugs - Category: Drugs & Pharmacology Source Type: research
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