RT Journal Article SR Electronic T1 Incidence of osteoporosis and fragility fractures in asthma: a UK population-based matched cohort study JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP 2001251 DO 10.1183/13993003.01251-2020 A1 Christos V. Chalitsios A1 Tricia M. McKeever A1 Dominick E. Shaw YR 2020 UL http://erj.ersjournals.com/content/early/2020/08/03/13993003.01251-2020.abstract AB Background Osteoporosis and fragility fractures (FF) are associated with corticosteroids which are the mainstay treatment for asthma; however, these bone comorbidities within asthma need to be better described.Methods A matched cohort study was conducted using the Clinical Practice Research Database (CPRD). Adults with an incident asthma code were identified and matched, with up to four randomly selected people without asthma, by age, gender, and practice. Osteoporosis and FF incidence rates were calculated, and Cox regression was performed comparing hazard rates to the general population. We report the impact of age, gender, glucocorticoids, and the risk of specific fractures.Results Patients with asthma had a higher risk of osteoporosis (aHR=1.18, 95% CI: 1.13–1.23) and were 12% (aHR=1.12, 95% CI: 1.07–1.16) more likely to sustain FF than the general population. Age modified the effect of asthma on osteoporosis and FF, such that effect to be stronger in younger people (pinteraction<0.0001). Vertebral (aHR=1.40, 95% CI: 1.33–1.48), and forearm-wrist (aHR=1.27, 95% CI: 1.22–1.32) were the sites linked with a larger incidence. A dose-response relationship between oral corticosteroids (OCS) and osteoporosis was observed, whereas the risk of FF increased in those with 6 or more OCS courses per year. Regular use of inhaled corticosteroids (ICS) increased the risk of both bone conditions.Conclusion Patients with asthma are more likely to develop osteoporosis or sustain FF than the general population with a particular concern in younger people and those more frequently using OCS and ICS.FootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Mr. Chalitsios has nothing to disclose.Conflict of interest: Prof. McKeever has nothing to disclose.Conflict of interest: Prof. Shaw has nothing to disclose.