Asthma and eczema can increase the risk of osteoporosis

A new study suggests that people with atopic (allergic) diseases, such as asthma or eczema, may be at increased risk of osteoporosis.

The paper, published in the Annals of the Rheumatic Diseases journal, indicates that medications used to reduce the physiological triggers of allergic reactions in the body may help reduce the risk of this painful, often disabling joint condition.

Osteoarthritis is the most common form of arthritis. But despite the disease's high prevalence, prohibitive costs, and devastating impact, there is still no effective treatment. Treatment primarily focuses on managing symptoms.

Mounting evidence suggests that activation of a type of white blood cell called mast cell and inflammatory chemicals (cytokines) involved in allergic reactions may play a key role in the development of arthritis. But it wasn't clear if people with allergic asthma or eczema were at risk of developing the condition.

To find out, the researchers relied on claims submitted to the US nationwide insurance database (Optum CDM) between January 2003 and June 2019, and electronic health records from the Stanford Research Repository (STARR) for the period from 2010 to 2020.

In all, 117,346 people with allergic asthma or eczema (median age 52 years, 60% of them women) and 1,247,196 people without atopic disease (median age 50 years, 48% of women) were identified in the insurance claims database.

About 109,899 people with atopic disease were matched with 109,899 people without allergic asthma or eczema in terms of age, sex, race, education level, underlying conditions, length of observation and outpatient visits.

The risk of developing osteoarthritis (or osteoarthritis, the most common form of arthritis, affecting millions of people worldwide) over a mean observational period of 8 years was 58% higher in those with asthma or allergic eczema than in those without atopic disease.

In other words, there would be 27 new cases versus 19 new cases if 100 people with and without atopy were monitored for 10 years each.

Of the 11,820 people with allergic asthma alone, they were 83 percent more likely to develop osteoporosis over an 8-year period than those with chronic obstructive pulmonary disease (COPD), a lung disease that does not involve allergic pathways.

The researchers then compared the risk of osteoarthritis between those with allergic asthma/eczema and those without allergies from the STARR health records to see if they could get similar results.

The STARR participants consisted of 114,427 patients, including 43,728 with allergic asthma or eczema and 70,699 with no history of atopic disease.

This dataset also included information on weight (body mass index), which is a significant risk factor for osteoporosis.

After adjusting for BMI, the odds of developing osteoporosis were 42% higher among people with allergic asthma or eczema, and 19% higher among those with both.

The researchers acknowledge various limitations of their findings, including reliance on insurance claims data for a portion of the study that did not include information on potential influencing factors, such as body mass index, previous joint injury, or levels of physical activity.

However, the authors concluded, “People with atopic disease have an increased risk of developing osteoporosis compared to the general population.” The association between atopic disease and osteoporosis is supported by recent observations that mast cells and type II cytokines may play an important role in the pathogenesis of the disease. widespread, not only in patients with atopic disease."

The team added: "Our findings provide additional support to the concept that allergic pathways may contribute to the development of osteoporosis. If this is indeed true, non-atopic patients may also benefit from the use of therapies that inhibit mast cells and allergic cytokines to treat or prevent osteoporosis." .