{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T04:17:58Z","timestamp":1789013878915,"version":"build-2803163510"},"reference-count":57,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,2,1]],"date-time":"2024-02-01T00:00:00Z","timestamp":1706745600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100008218","name":"Gangstedfonden","doi-asserted-by":"publisher","award":["A38495"],"award-info":[{"award-number":["A38495"]}],"id":[{"id":"10.13039\/501100008218","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Br J Haematol"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Corticosteroids remain the first\u2010line treatment of immune thrombocytopenia (ITP), but increase the risk of osteoporosis and fractures. Bisphosphonates are used for the treatment of osteoporosis, but their usage among patients with ITP has not been systemically described. We investigated the risk of fractures and the use of bisphosphonates in adult patients with primary (pITP) and secondary ITP (sITP) compared with matched comparators in a nationwide registry\u2010based cohort study. We identified 4030 patients with pITP (median age 60\u2009years [IQR, 40\u201374]), 550 with sITP (median age 59\u2009years [IQR, 43\u201374]) and 182\u2009939 age\u2013sex\u2010matched general population comparators. All individuals were followed for incident fractures. Bisphosphonate use was estimated for calendar\u2010years and in temporal relation to the ITP diagnosis. Adjusted cause\u2010specific hazard ratio (csHR) for any fracture was 1.37 (95% confidence interval [CI] 1.23; 1.54) for pITP and 1.54 (1.17; 2.03) for sITP. The first\u2010year csHR was 1.82 (1.39; 2.40) for pITP and 2.78 (1.58; 4.91) for sITP. Bisphosphonate use over calendar\u2010years and in the early years following ITP diagnosis was higher among patients with ITP diagnosis compared with the general population. In conclusion, the risk of fractures and the use of bisphosphonates are higher in patients with ITP compared with the general population.<\/jats:p>","DOI":"10.1111\/bjh.19301","type":"journal-article","created":{"date-parts":[[2024,2,2]],"date-time":"2024-02-02T00:35:13Z","timestamp":1706834113000},"page":"1464-1475","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Risk of fractures and use of bisphosphonates in adult patients with immune thrombocytopenia\u2014A nationwide population\u2010based study"],"prefix":"10.1111","volume":"204","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1098-8134","authenticated-orcid":false,"given":"Nikolaj","family":"Mannering","sequence":"first","affiliation":[{"name":"Department of Haematology Odense University Hospital  Odense Denmark"},{"name":"Department of Clinical Research University of Southern Denmark  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4478-1297","authenticated-orcid":false,"given":"Dennis Lund","family":"Hansen","sequence":"additional","affiliation":[{"name":"Department of Haematology Odense University Hospital  Odense Denmark"},{"name":"Department of Clinical Research University of Southern Denmark  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillaume","family":"Moulis","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine University Hospital Centre Toulouse  Toulouse France"},{"name":"Clinical Investigation Center 1436, Team PEPSS University Hospital Centre Toulouse  Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Waleed","family":"Ghanima","sequence":"additional","affiliation":[{"name":"\u00d8stfold Hospital  Oslo Norway"},{"name":"Institute for Clinical Medicine University of Oslo  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anton","family":"Potteg\u00e5rd","sequence":"additional","affiliation":[{"name":"Department of Public Health University of Southern Denmark  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8905-0220","authenticated-orcid":false,"given":"Henrik","family":"Frederiksen","sequence":"additional","affiliation":[{"name":"Department of Haematology Odense University Hospital  Odense Denmark"},{"name":"Department of Clinical Research University of Southern Denmark  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,2]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12185-013-1370-4"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.17212"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.12869"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.20992"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/17474086.2018.1548930"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2010-10-312819"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/17474086.2021.1976635"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2010.08418.x"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2009-01-129155"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2019000966"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2016.09.001"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/jha2.684"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-007-0394-0"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2474-12-105"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.160.19.2917"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.22294"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V94.3.909.415k02_909_913"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cdtm.2015.02.006"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2021.2617"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1080\/17453674.2019.1680485"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.3109\/09537104.2012.690544"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2796.2003.01219.x"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1177\/1076029609350889"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lfs.2020.118681"},{"issue":"3","key":"e_1_2_10_26_1","first-page":"798","article-title":"Data resource profile: the Danish National Prescription Registry","volume":"46","author":"Pottegard A","year":"2017","journal-title":"Int J Epidemiol"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.2147\/CLEP.S91125"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-014-9930-3"},{"key":"e_1_2_10_29_1","first-page":"7","article-title":"Validity of a procedure to identify patients with chronic idiopathic thrombocytopenic purpura in the Danish National Registry of patients","volume":"1","author":"Heden KE","year":"2009","journal-title":"Clin Epidemiol"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1177\/1403494811399958"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1177\/1403494811401482"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1177\/1403494810394717"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.12581"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwq433"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-11-83"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.326.7382.219"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.1999.10474144"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2012.09.017"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.4081\/or.2019.7774"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2009.06.021"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1136\/rmdopen-2014-000014"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7525-6-13"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bone.2011.11.009"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.22117"},{"key":"e_1_2_10_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(94)91049-9"},{"key":"e_1_2_10_46_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-010-1319-x"},{"key":"e_1_2_10_47_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2006.06269.x"},{"key":"e_1_2_10_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2009.09.006"},{"key":"e_1_2_10_49_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11899-019-00508-w"},{"key":"e_1_2_10_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2017.06.010"},{"key":"e_1_2_10_51_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hoc.2009.08.006"},{"key":"e_1_2_10_52_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.seminhematol.2008.12.005"},{"key":"e_1_2_10_53_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.18104"},{"key":"e_1_2_10_54_1","doi-asserted-by":"publisher","DOI":"10.1080\/10428190701471973"},{"key":"e_1_2_10_55_1","doi-asserted-by":"publisher","DOI":"10.1080\/10428194.2020.1723015"},{"issue":"1","key":"e_1_2_10_56_1","first-page":"31","article-title":"Diagnoses, outcomes, and chronicity predictors of patients with secondary immune thrombocytopenia: ten\u2010year data from a hematology referral Center","volume":"73","author":"Jaime\u2010Perez JC","year":"2020","journal-title":"Rev Investig Clin"},{"issue":"2","key":"e_1_2_10_57_1","first-page":"121","article-title":"Effect of glucocorticoids on bone mineral density in patients with idiopathic thrombocytopenic purpura","volume":"46","author":"Hasegawa M","year":"2005","journal-title":"Rinsho Ketsueki"},{"key":"e_1_2_10_58_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2017010942"}],"container-title":["British Journal of Haematology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/bjh.19301","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,10]],"date-time":"2024-04-10T15:36:53Z","timestamp":1712763413000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/bjh.19301"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2]]},"references-count":57,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2024,4]]}},"alternative-id":["10.1111\/bjh.19301"],"URL":"https:\/\/doi.org\/10.1111\/bjh.19301","archive":["Portico"],"relation":{},"ISSN":["0007-1048","1365-2141"],"issn-type":[{"value":"0007-1048","type":"print"},{"value":"1365-2141","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2]]},"assertion":[{"value":"2023-10-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-04","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-02-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}