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Immune-mediated diseases, steroids, and PPI use have been linked to osteoporosis. We assessed the risk of fractures in patients with EoE and determined whether the most commonly used treatments for EoE were associated with increased fracture risk.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We followed a nationwide cohort of 1263 individuals in Sweden with biopsy-verified EoE diagnosed between 2005 and 2016 for first-time fracture of any type. Age- and sex-matched reference individuals were retrieved from the Total Population Register (<jats:italic>n<\/jats:italic>\u2009=\u20095164). We estimated hazard ratios (HRs) for fracture in relation to EoE diagnosis, steroid exposure, and PPI use. In a separate analysis, we compared fracture risk among individuals with EoE to their siblings (<jats:italic>n<\/jats:italic>\u2009=\u20091394).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>During 4521 person-years of follow-up, 69 individuals with EoE experienced a first-time fracture (15.3\/1000 person-years) compared with 234 reference individuals (12.6\/1000 person-years). After adjusting for age, sex, birth year, and county of residence, EoE was not associated with a statistically significantly increased risk of fractures (HR\u2009=\u20091.2, 95% CI\u2009=\u20090.9\u20131.6). Among EoE individuals, exposure to PPIs and swallowed steroids did not modify the risk of fracture (p for heterogeneity 0.20 and 0.07 respectively). There was no increased risk of fractures in EoE compared to EoE-free siblings.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>The risk of fracture in EoE was not statistically significantly elevated compared to non-EoE reference individuals. Fracture risk in EoE was not modified by PPIs or steroid use.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s10388-022-00929-2","type":"journal-article","created":{"date-parts":[[2022,6,28]],"date-time":"2022-06-28T20:18:59Z","timestamp":1656447539000},"page":"542-553","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Risk of fractures in individuals with eosinophilic esophagitis: nationwide population-based cohort study"],"prefix":"10.1007","volume":"19","author":[{"given":"John J.","family":"Garber","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bjorn","family":"Roelstraete","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul J.","family":"Lochhead","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amiko M.","family":"Uchida","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karl","family":"Micha\u00eblsson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ola","family":"Ol\u00e9n","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1024-5602","authenticated-orcid":false,"given":"Jonas F.","family":"Ludvigsson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,6,28]]},"reference":[{"issue":"2","key":"929_CR1","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1053\/j.gastro.2017.06.065","volume":"154","author":"KM O'Shea","year":"2018","unstructured":"O\u2019Shea KM, Aceves SS, Dellon ES, et al. 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Dr. Ol\u00e9n has been PI on projects partly financed by investigator-initiated grants from Janssen and Ferring, and also on a grant from Pfizer in the context of a national safety monitoring program. None of those studies have any relation to the present study. Karolinska Institutet has received fees for lectures and participation on advisory boards from Janssen, Ferring, Takeda, and Pfizer regarding topics not related to the present study. Dr Uchida is on a Medical Advisory Board for Sanofi-Regeneron (unrelated to this study). Dr. Ludvigsson coordinates a study on behalf of the Swedish IBD quality register (SWIBREG). That study has received funding from Janssen corporation.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}