No increased risk of osteoporotic fracture in myasthenia gravis despite corticosteroid therapy

A study conducted in Denmark in 376,858 adults who presented with a so-called “major” osteoporotic fracture (hip, radius, humerus or vertebra) between 1995 and 2011, compared to 376,858 control adults, shows that: 

  • the risk of this type of complication is not increased in patients with autoimmune myasthenia gravis on corticosteroid therapy, compared to those who are not treated with corticosteroids; 
  • the highest cumulative doses of oral corticosteroid therapy (≥ 7 g prednisolone equivalent) are also not associated with an increased risk of osteoporotic fracture in these same patients.

However, these results should be interpreted with caution given the small number (236) of patients with myasthenia gravis in this study. The authors recommend a co-prescription of bisphosphonates with corticosteroid therapy. 

 

The use of oral glucocorticoids and the risk of major osteoporotic fracture in patients with myasthenia gravis. Safipour Z, van der Zanden R, van den Bergh J et al. Osteoporos Int. 2021 Oct 3.