Risk of fracture in patients with myasthenia gravis: a nationwide cohort study in Korea
Authors' conclusion
In summary, patients with MG had higher risk of major osteoporotic fracture compared with controls
Study context
- Population
- Patients with myasthenia gravis (MG) and matched controls, Korean National Health Insurance Service claims 2002–2020; MG mean age 53.7 years, 55% womenmatched cohort
- Participants
- 23,118 vs 115,590
- Exposure
- MG vs age- and sex-matched controls
- MGn = 23,118
- Controlsn = 115,590reference
- Outcome
- Major osteoporotic fracture
- Follow-up
- Median 5.58 years
Methodological detailsage- and sex-matched controls, multivariable Cox proportional hazard models, claims database
- Age- and sex-matched controls
- Multivariable Cox proportional hazard models
- Claims database
Main finding
As reported in the abstract
Adjusted hazard ratio
1.19
P < 0.001
adjusted for age, sex, comorbidities, drug use incl. anti-osteoporotic agents, previous fracture
Subdistributed HR
1.14
P < 0.001
mortality as competing risk
MG
13.59 per 10 000 person-years
Controls
9.74 per 10 000 person-years
Observational data: associations, not effects.
Further findings
Major osteoporotic fracture by age subgroup
- aHR, age ≤50 vs older
- 1.34 vs. 1.17
- P for interaction
- < 0.05
Major osteoporotic fracture by sex subgroup
- aHR, men vs women
- 1.32 vs. 1.15
- P for interaction
- < 0.05
Fracture site
- Imminent divergence of risk curves for vertebral fracture; time delay for non-vertebral sites
Risk factors for fracture in MG
- Older age, female gender, high dose glucocorticoid use (>7.5 mg/day), immunosuppressant use, previous fracture
Original publication
Risk of fracture in patients with myasthenia gravis: a nationwide cohort study in Korea. J Bone Miner Res. Published 12 March 2024. doi:10.
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