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November 12, 2014
Eczema Medications Linked to Greater Injury
Chicago—As if intense itching and painfully dry skin weren’t problem enough, eczema patients also face a greater risk of broken bones and other injuries, likely related to the medications they use.
Rates in Patients That’s according to a new study from Northwestern Medicine in Chicago, suggesting that the increased odds of accidental injury might be directly related to the side effects of steroids and sedating antihistamines, which are commonly prescribed to treat atopic dermatitis. The report was published recently in JAMA Dermatology. “Many eczema patients who are prescribed medication for itch are often given sedating antihistamines or steroids, but those medications may come at a price,” explained senior author Jonathan I. Silverberg, MD. “Sedatives cause fatigue, and steroids can lead to bone density problems and osteoporosis.” The problem is that intense itching caused by the skin disorder also disrupts quality of life. “It makes it almost impossible to function normally at work and to take care of the activities of daily living,” Silverberg said. “The itch is waking patients up from their sleep at night, much in the way that chronic pain patients have difficulties sleeping.” For the prospective questionnaire-based study, researchers used the 2012 National Health Interview Survey of about 30,000 adults, focusing on history of fracture and bone or joint injury (FBJI) and other injuries creating limitations. Results indicate that patients who had a flare-up of eczema within the past year had 44% higher odds of all injuries, especially FBJI. The prevalence of broken bones or joint injuries increased gradually over time, more than doubling from the 30 to 49 age group to the 50 to 69 age group, then decreasing in older adults who were less active. Injury rates were even higher in eczema patients who also reported fatigue (aOR, 1.59; 95% CI, 1.16-2.19), daytime sleepiness (aOR, 1.81; 95% CI, 1.28-2.55), or insomnia (aOR, 1.74; 95% CI, 1.28-2.37). Another factor increasing fractures and joint injuries was concurrent eczema and psychiatric and behavioral disorders. “Some of these patients are probably undertreated and aren't getting any relief, and they can't sleep,” Silverberg said. “The results of this study suggest that eczema in adulthood is a previously unrecognized risk factor for fracture and other injury causing limitation,” the authors write. “Future studies are needed to confirm these associations. The findings may warrant the development of preventive measures for injury risk reduction in adult patients with eczema.” Pharmacists and other healthcare providers should advise eczema patients to develop strategies to minimize falls and traumatic injuries and to avoid potentially dangerous behaviors such as driving while using sedating antihistamines, according to the article. |
U.S. Pharmacist Social Connect
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