Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Oral steroids plus PPIs increase osteoporotic fracture risk in RA patients

Key clinical point: RA patients on both oral glucocorticoids (CGs) and proton pump inhibitors (PPIs) had an increased risk of osteoporotic fractures, including to the ribs and vertebrae.

Major finding: Concomitant users of oral GCs and PPIs had a notably higher risk of fracture (adjusted hazard ratio, 1.60; 95% CI, 1.35-1.89).

Study details: A retrospective, population-based cohort study of RA patients aged 50 years or older in the United Kingdom.

Disclosures: Two of the authors reported receiving research grants and speakers’ fees from various pharmaceutical companies. The others reported no conflicts of interest.


Abtahi S et al. Ann Rheum Dis. 2020 Dec 11. doi: 10.1136/annrheumdis-2020-218758.