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The association between myasthenia gravis and risk of fracture: a systematic review and meta-analysis

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Abstract

Patients with myasthenia gravis (MG), because of their muscle weakness and exposure to corticosteroids treatment, are generally considered to be at increased risk for osteoporosis or fracture. However, clinical evidence of this issue is lacking. In this review, we systematically searched databases, including Cochrane Library, PubMed, Embase, and Airiti library from inception to the end of November 2023 for cohort studies that compared participants with MG and participants without MG for incidence of osteoporosis or fracture. We used the Newcastle–Ottawa Scale for quality assessment. In total, we included 3 studies with 34,865 participants. The pooled meta-analysis using the random effect model demonstrated no significant difference in risk of fracture in the MG group (odds ratio = 1.52; 95% confidence interval = 0.74 to 3.12; I2 = 93%; between-study variance [τ2] = 0.32) compared with that for the non-MG group. Due to limited studies, we could not perform a quantitative analysis for risk of osteoporosis. In conclusion, we found no robust evidence to support the proposition that patients with MG are at higher risk for fracture than general comparators. The explanations and underlying mechanisms of this finding remain unclear, we therefore conclude that additional studies are warranted.

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Acknowledgements

We would like to thank Enago (www.enago.com) for editing and proofreading this manuscript.

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Authors and Affiliations

  1. Department of Family Medicine, Hsinchu MacKay Memorial Hospital, Hsinchu City, Taiwan

    Chien-Ju Lin & Yu-Shan Lee

  2. Department of Neurology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei City, Taiwan

    Jiann-Horng Yeh & Kuan-Yu Lin

  3. School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan

    Jiann-Horng Yeh

  4. Department of Medical Library, MacKay Memorial Hospital, Tamsui Branch, New Taipei City, Taiwan

    Shu-Jung Liu

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Chien-Ju Lin, Yu-Shan Lee, Jiann-Horng Yeh, Shu-Jung Liu, and Kuan-Yu Lin declare that they have no conflict of interest.

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Lin, CJ., Lee, YS., Yeh, JH. et al. The association between myasthenia gravis and risk of fracture: a systematic review and meta-analysis. Osteoporos Int (2024). https://doi.org/10.1007/s00198-024-07097-2

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