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Study refutes link between fracture risk and use of vitamin A-related substances
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Topical and systemic vitamin A analogues do not alter fracture risk, according to a Danish database study in which patients with fractures were matched to three demographically similar patients without fractures.
Very high doses of vitamin A analogues—compounds similar to vitamin A prescribed to treat acne, psoriasis and other skin conditions—have previously been linked to impairment of the markers involved in bone reconstruction and bone mineral density, according to investigator Peter Vestergaard, MD, PhD, DrMedSc., at Aarhus University Hospital, in Aarhus, Denmark, and colleagues.
But they wrote in the conclusion of their study, which was published in Archives of Dermatology, “It thus seems that vitamin A analogues are safe in terms of fractures even at very high doses.”
Identifying fracture risk
Vestergaard and colleagues analyzed data from a nationwide Danish registry for 124,655 patients who sustained fractures in the year 2000 and 373,962 age- and sex-matched individuals. Their goal was to arrive at the incidence of fractures in those exposed to systemic vitamin A analogues vs. who those not exposed to these substances.
The researchers controlled their investigation for possibly confounding factors, such as social variables, contact with hospitals and care providers, alcoholism and any factors known to possibly affect fracture risk, such as use of corticosteroids and anti-epileptic medications.
Yet when Vestergaard and colleagues matched one fracture patient each with three controls, they found that neither topical nor systemic vitamin A analogues were associated with the change in fracture risk at any skeletal site. Furthermore, even large daily doses —14 mg — of vitamin A analogues were not associated with an increased risk of fracture, nor was acne or psoriasis medication, according to an Archives press release.
- Reference:
Vestergaard P, Rejnmark L and Mosekilde L. High-dose treatment with vitamin A analogues and risk of fractures.Arch Dermatol. 2010;146(5):478-482.
Vestergaard’s study was supported by a grant from the Danish Medical Research Council.
