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Correspondence
Medications associated with fracture risk in patients with rheumatoid arthritis
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  1. Yi-Sheng Liou1,2,
  2. Tsung-Kun Lin3,4,
  3. Hung-Yi Chen5,6,
  4. Gwo-Ping Jong7,8
  1. 1 Department of Family Medicine and Geriatrics, Taichung Veterans General Hospital, Taichung, Taiwan
  2. 2 School of Public Health, National Defense Medical Center, Taipei, Taiwan
  3. 3 Department of Pharmacy, Taoyuan Armed Forces General Hospital, Lungtan, Taiwan
  4. 4 School of Pharmacy, National Defense Medical Center, Taipei, Taiwan
  5. 5 Department of Pharmacy, China Medical University, Taichung, Taiwan
  6. 6 Department of Pharmacy, China Medical University Beigang Hospital, Beigang, Taiwan
  7. 7 Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
  8. 8 Department of Medicine, Chung Shan Medical University, Taichung, Taiwan
  1. Correspondence to Dr Gwo-Ping Jong, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung 40201, Taiwan; cgp8009{at}yahoo.com.tw

https://doi.org/10.1136/annrheumdis-2019-216262

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    Statins have been widely used to control dyslipidaemia, and there is strong evidence for beneficial effects for patients at risk for cardiovascular diseases.1 2 In particular, statins may influence bone metabolism by increasing bone formation.3 4 Recently, Ozen et al 5 reported that medication with opioids, selective serotonin reuptake inhibitors, and glucocorticoids were associated with an increased risk of osteoporosis-related site fractures (vertebra, hip, forearm and humerus) in patients with rheumatoid arthritis, whereas statins and tumour necrosis factor-α inhibitors were associated with a decreased risk of vertebral fractures. These findings were published in the August 2019 issue of the Annals of the Rheumatic Diseases. Certainly, the findings of Ozen et al 5 will be significant for clinicians; however, four points remain unaddressed that we would like to communicate with the authors.

    First, the prevalence of osteoporotic fracture has been reported to be significantly higher in patients with chronic diseases …

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