email article Patients with rheumatoid arthritis (RA) who were treated with oral glucocorticoids and proton pump inhibitors (PPIs) were at increased risk for osteoporotic fracture, a large cohort study found. Patients who were concomitant users of glucocorticoids and PPIs had a 1.6-fold increased risk of osteoporotic fracture (adjusted HR 1.60, 95% CI 1.35-1.89), reported Frank de Vries, PharmD, PhD, of Utrecht University in the Netherlands, and colleagues. In contrast, for those who used either oral glucocorticoids or PPIs alone, the risk was only 1.2-fold higher. For glucocorticoid use alone, the adjusted hazard ratio was 1.23 (95% CI 1.03-1.47), while for PPI use the hazard ratio was 1.22 (95% CI 1.05-1.42), which were statistically lower than for concomitant use of the two, according to the team's study online in