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Erschienen in: Osteoporosis International 7/2014

01.07.2014 | Original Article

Risk of fracture in patients with Guillain-Barré syndrome

verfasst von: S. Pouwels, A. de Boer, H. G. M. Leufkens, W. E. J. Weber, C. Cooper, T. P. van Staa, F. de Vries

Erschienen in: Osteoporosis International | Ausgabe 7/2014

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Abstract

Summary

The aim of this study was to evaluate fracture risk in patients with Guillain-Barré syndrome (GBS). No association with risk of fracture was observed for GBS patients compared with controls. Only GBS patients using pain treatment had a doubled risk of fracture.

Introduction

Symptoms of Guillain-Barré syndrome (GBS) may vary from mild difficulty in walking to complete paralysis, which may increase the risk of fractures. Therefore, the aim of this study was to evaluate fracture risk in patients with GBS.

Methods

We conducted a retrospective cohort study using the UK Clinical Practice Research Datalink (1987–2012). Each patient with GBS was matched by year of birth, sex, and practice, up to six patients without a history of GBS. Outcome measure was any fracture.

Results

There were no associations between GBS and any fracture, adjusted hazard ratio (AHR) 1.01 (95 % confidence interval [CI] 0.77–1.33), or osteoporotic fracture, AHR 0.76 (95 % CI 0.50–1.17), compared with controls. Stratification to gender, age, and duration since diagnosis did not show an association either. Only for GBS patients using pain treatment, risk of fracture was doubled AHR 1.97 (95 % confidence CI 1.21–3.21) compared with controls. The risk of fracture in GBS patients exposed to pain treatment was equivalent to risk of fracture among controls exposed to pain treatment.

Conclusions

No association with risk of fracture was observed for GBS patients compared with controls. Only GBS patients using pain treatment had a doubled risk of fracture, but their risk was equivalent to fracture risk among controls exposed to pain treatment.
Literatur
2.
Zurück zum Zitat Rees JH, Thompson RD, Smeeton NC, Hughes RA (1998) Epidemiological study of Guillain-Barré syndrome in south east England. J Neurol Neurosurg Psychiatry 64(1):74–77PubMedCentralPubMedCrossRef Rees JH, Thompson RD, Smeeton NC, Hughes RA (1998) Epidemiological study of Guillain-Barré syndrome in south east England. J Neurol Neurosurg Psychiatry 64(1):74–77PubMedCentralPubMedCrossRef
4.
Zurück zum Zitat Clouston WM, Lloyd HM (1987) Immobilization-induced hypercalcemia and regional osteoporosis. Clin Orthop Relat Res 216:247–252PubMed Clouston WM, Lloyd HM (1987) Immobilization-induced hypercalcemia and regional osteoporosis. Clin Orthop Relat Res 216:247–252PubMed
5.
Zurück zum Zitat Forrest G, Huss S, Patel V, Jeffries J, Myers D, Barber C, Kosier M (2012) Falls on an inpatient rehabilitation unit: risk assessment and prevention. Rehabil Nurs 37(2):56–61PubMedCrossRef Forrest G, Huss S, Patel V, Jeffries J, Myers D, Barber C, Kosier M (2012) Falls on an inpatient rehabilitation unit: risk assessment and prevention. Rehabil Nurs 37(2):56–61PubMedCrossRef
6.
Zurück zum Zitat Jaul E, Malcov T, Menczel J (2009) Osteoporosis in tube-fed bed-ridden elderly female patients. J Am Geriatr Soc 57(7):1318–1320PubMedCrossRef Jaul E, Malcov T, Menczel J (2009) Osteoporosis in tube-fed bed-ridden elderly female patients. J Am Geriatr Soc 57(7):1318–1320PubMedCrossRef
7.
Zurück zum Zitat Belavy DL, Beller G, Ritter Z, Felsenberg D (2011) Bone structure and density via HR-pQCT in 60d bed-rest, 2-years recovery with and without countermeasures. J Musculoskelet Neuronal Interact 11(3):215–226PubMed Belavy DL, Beller G, Ritter Z, Felsenberg D (2011) Bone structure and density via HR-pQCT in 60d bed-rest, 2-years recovery with and without countermeasures. J Musculoskelet Neuronal Interact 11(3):215–226PubMed
8.
Zurück zum Zitat Vestergaard P, Rejnmark L, Mosekilde L (2006) Fracture risk associated with the use of morphine and opiates. J Intern Med 260(1):76–87PubMedCrossRef Vestergaard P, Rejnmark L, Mosekilde L (2006) Fracture risk associated with the use of morphine and opiates. J Intern Med 260(1):76–87PubMedCrossRef
9.
Zurück zum Zitat Souverein PC, Webb DJ, Weil JG, Van Staa TP, Egberts AC (2006) Use of antiepileptic drugs and risk of fractures: case–control study among patients with epilepsy. Neurology 66(9):1318–1324PubMedCrossRef Souverein PC, Webb DJ, Weil JG, Van Staa TP, Egberts AC (2006) Use of antiepileptic drugs and risk of fractures: case–control study among patients with epilepsy. Neurology 66(9):1318–1324PubMedCrossRef
10.
Zurück zum Zitat van den Brand MW, Samson MM, Pouwels S, van Staa TP, Thio B, Cooper C, Leufkens HG, Egberts AC, Verhaar HJ, de Vries F (2009) Use of anti-depressants and the risk of fracture of the hip or femur. Osteoporos Int 20(10):1705–1713PubMedCentralPubMedCrossRef van den Brand MW, Samson MM, Pouwels S, van Staa TP, Thio B, Cooper C, Leufkens HG, Egberts AC, Verhaar HJ, de Vries F (2009) Use of anti-depressants and the risk of fracture of the hip or femur. Osteoporos Int 20(10):1705–1713PubMedCentralPubMedCrossRef
11.
Zurück zum Zitat Vestergaard P, Hermann P, Jensen JE, Eiken P, Mosekilde L (2012) Effects of paracetamol, non-steroidal anti-inflammatory drugs, acetylsalicylic acid, and opioids on bone mineral density and risk of fracture: results of the Danish Osteoporosis Prevention Study (DOPS). Osteoporos Int 23(4):1255–1265PubMedCrossRef Vestergaard P, Hermann P, Jensen JE, Eiken P, Mosekilde L (2012) Effects of paracetamol, non-steroidal anti-inflammatory drugs, acetylsalicylic acid, and opioids on bone mineral density and risk of fracture: results of the Danish Osteoporosis Prevention Study (DOPS). Osteoporos Int 23(4):1255–1265PubMedCrossRef
12.
Zurück zum Zitat Hughes RA, Wijdicks EF, Benson E, Cornblath DR, Hahn AF, Meythaler JM, Sladky JT, Barohn RJ, Stevens JC, Multidisciplinary Consensus Group (2005) Supportive care for patients with Guillain-Barré syndrome. Arch Neurol 62(8):1194–1198PubMedCrossRef Hughes RA, Wijdicks EF, Benson E, Cornblath DR, Hahn AF, Meythaler JM, Sladky JT, Barohn RJ, Stevens JC, Multidisciplinary Consensus Group (2005) Supportive care for patients with Guillain-Barré syndrome. Arch Neurol 62(8):1194–1198PubMedCrossRef
13.
Zurück zum Zitat Walley T, Mantgani A (1997) The UK general practice research database. Lancet 350:1097–1099PubMedCrossRef Walley T, Mantgani A (1997) The UK general practice research database. Lancet 350:1097–1099PubMedCrossRef
14.
Zurück zum Zitat Van Staa TP, Abenhaim L (1994) The quality of information recorded on a UK database of primary care records: a study of hospitalization due to hypoglycemia and other conditions. Pharmacoepidemiol Drug Saf 3:15–21CrossRef Van Staa TP, Abenhaim L (1994) The quality of information recorded on a UK database of primary care records: a study of hospitalization due to hypoglycemia and other conditions. Pharmacoepidemiol Drug Saf 3:15–21CrossRef
15.
Zurück zum Zitat Van Staa TP, Abenhaim L, Cooper C, Begaud B, Zhang B, Leufkens HG (2000) The use of a large pharmaco-epidemiological database to study exposure to oral glucocorticoids and risk of fractures: validation of study population and results. Pharmacoepidemiol Drug Saf 9:359–366PubMedCrossRef Van Staa TP, Abenhaim L, Cooper C, Begaud B, Zhang B, Leufkens HG (2000) The use of a large pharmaco-epidemiological database to study exposure to oral glucocorticoids and risk of fractures: validation of study population and results. Pharmacoepidemiol Drug Saf 9:359–366PubMedCrossRef
17.
Zurück zum Zitat Kanis JA, Oden A, Johnell O, Jonsson B, de Laet C, Dawson A (2001) The burden of osteoporotic fractures: a method for setting intervention thresholds. Osteoporos Int 12(5):417–427PubMedCrossRef Kanis JA, Oden A, Johnell O, Jonsson B, de Laet C, Dawson A (2001) The burden of osteoporotic fractures: a method for setting intervention thresholds. Osteoporos Int 12(5):417–427PubMedCrossRef
18.
Zurück zum Zitat Visser LH, Schmitz PI, Meulstee J, van Doorn PA, van der Meché FG (1999) Prognostic factors of Guillain-Barré syndrome after intravenous immunoglobulin or plasma exchange. Dutch Guillain-Barré Study Group. Neurology 53(3):598–604PubMedCrossRef Visser LH, Schmitz PI, Meulstee J, van Doorn PA, van der Meché FG (1999) Prognostic factors of Guillain-Barré syndrome after intravenous immunoglobulin or plasma exchange. Dutch Guillain-Barré Study Group. Neurology 53(3):598–604PubMedCrossRef
19.
Zurück zum Zitat Winer JB, Hughes RA, Osmond C (1988) A prospective study of acute idiopathic neuropathy. I. Clinical features and their prognostic value. J Neurol Neurosurg Psychiatry 51(5):605–612PubMedCentralPubMedCrossRef Winer JB, Hughes RA, Osmond C (1988) A prospective study of acute idiopathic neuropathy. I. Clinical features and their prognostic value. J Neurol Neurosurg Psychiatry 51(5):605–612PubMedCentralPubMedCrossRef
20.
Zurück zum Zitat Vestergaard P (2008) Pain-relief medication and risk of fractures. Curr Drug Saf 3(3):199–203PubMedCrossRef Vestergaard P (2008) Pain-relief medication and risk of fractures. Curr Drug Saf 3(3):199–203PubMedCrossRef
21.
Zurück zum Zitat Ali II, Schuh L, Barkley GL, Gates JR (2004) Antiepileptic drugs and reduced bone mineral density. Epilepsy Behav 5(3):296–300PubMedCrossRef Ali II, Schuh L, Barkley GL, Gates JR (2004) Antiepileptic drugs and reduced bone mineral density. Epilepsy Behav 5(3):296–300PubMedCrossRef
22.
Zurück zum Zitat van Staa TP, Leufkens HG, Cooper C (2000) Use of nonsteroidal anti-inflammatory drugs and risk of fractures. Bone 27(4):563–568PubMedCrossRef van Staa TP, Leufkens HG, Cooper C (2000) Use of nonsteroidal anti-inflammatory drugs and risk of fractures. Bone 27(4):563–568PubMedCrossRef
23.
Zurück zum Zitat Patwa HS, Chaudhry V, Katzberg H, Rae-Grant AD, So YT (2012) Evidence-based guideline: intravenous immunoglobulin in the treatment of neuromuscular disorders: report of the therapeutics and technology assessment subcommittee of the American academy of neurology. Neurology 78(13):1009–1015PubMedCrossRef Patwa HS, Chaudhry V, Katzberg H, Rae-Grant AD, So YT (2012) Evidence-based guideline: intravenous immunoglobulin in the treatment of neuromuscular disorders: report of the therapeutics and technology assessment subcommittee of the American academy of neurology. Neurology 78(13):1009–1015PubMedCrossRef
24.
Zurück zum Zitat Raphaël JC, Chevret S, Hughes RA, Annane D (2012) Plasma exchange for Guillain-Barré syndrome. Cochrane Database Syst Rev 7, CD001798PubMed Raphaël JC, Chevret S, Hughes RA, Annane D (2012) Plasma exchange for Guillain-Barré syndrome. Cochrane Database Syst Rev 7, CD001798PubMed
Metadaten
Titel
Risk of fracture in patients with Guillain-Barré syndrome
verfasst von
S. Pouwels
A. de Boer
H. G. M. Leufkens
W. E. J. Weber
C. Cooper
T. P. van Staa
F. de Vries
Publikationsdatum
01.07.2014
Verlag
Springer London
Erschienen in
Osteoporosis International / Ausgabe 7/2014
Print ISSN: 0937-941X
Elektronische ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-014-2705-6

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