NEW YORK (Reuters Health) – People who are treated with corticosteroids for the inflammatory bowel condition called Crohn’s disease have heightened odds of breaking a bone, according to researchers in Canada.
“Corticosteroid use has been considered in other diseases to be a risk for fracture, although not all studies in inflammatory bowel disease (IBD) are concordant on this point,” Dr. Charles N. Bernstein and associates at the University of Manitoba, write in the American Journal of Gastroenterology.
The term IBD covers Crohn’s disease as well as another condition called ulcerative colitis. To look into the effect of steroid treatment, the researchers compared 41 IBD patients who sustained a fracture with 276 matched but fracture-free IBD “controls.”
Thirteen patient with Crohn’s disease and 28 with ulcerative colitis had fractures.
Among the patients with Crohn’s disease, corticosteroids treatment had been given in the previous two years to 54 percent who had a fracture, but to only 22 percent of those without fracture, Bernstein’s team reports. The corresponding rates of steroid therapy for individuals with ulcerative colitis were 18 percent and 21 percent.
Based on these findings, the researchers conclude that corticosteroids may increase the risk of fractures for patients with Crohn’s disease, but not ulcerative colitis.
However, they point out, “this study does not establish irrefutably that corticosteroids are a key risk factor for fracture.” Individuals who require steroids may have more severe disease, and “it may have been the inflammatory disease that put those patients who fractured at principle risk.”
Nonetheless, the findings do show that Crohn’s disease patients who require corticosteroid treatment “should be considered at risk for fracture,” they conclude.
SOURCE: American Journal of Gastroenterology, August 2003.