BRACE-1

• Research type

  Research Study

• Full title

  The association between bone fractures and coeliac disease – is there a role for coeliac disease screening in fracture clinics?

• IRAS ID

  318226

• Contact name

  Ajay M Verma

• Contact email

  ajay.verma@nhs.net

• Sponsor organisation

  Kettering General Hospital NHS Foundation Trust

• Duration of Study in the UK

  0 years, 4 months, 30 days

• Research summary

  Coeliac disease is a medical condition where the body has an allergic reaction to gluten, a protein found in wheat, barley, and rye. When someone with coeliac disease eats gluten, it causes inflammation in their small intestine, which can lead to diarrhoea, abdominal pain, and other symptoms. It is a common condition with an approximate UK prevalence of 1%, and most individuals with coeliac disease are undiagnosed as lots of people with coeliac disease don't have any symptoms, and therefore they don't know they have it or their doctor doesn't recognize the symptoms. Coeliac disease can also affect bone health, as the body may not be able to absorb enough vitamin D, which can lead to osteoporosis or osteopenia (weaker bones). A study is being conducted to test the blood of adults with fractures for coeliac disease by looking for certain proteins (called coeliac antibodies). If the test is positive, the person will be referred to a gastroenterology specialist for further testing to see if they have coeliac disease. The goal of the study is to provide evidence for the recommendation of testing for coeliac disease in people with fractures.
  Lay summary of study results: We tested whether routinely screening people attending a fracture clinic (after breaking a bone) would identify new cases of coeliac disease.
  Between April 2023 and July 2025, 1,200 adults were included. Those without a known diagnosis of coeliac disease were offered a blood test commonly used to screen for the condition. If the test was positive, further investigations were carried out to confirm the diagnosis.
  Nine people (0.75%) had a positive screening test. Of these, six were confirmed to have coeliac disease following further testing. This means that only 0.5% of participants were newly diagnosed through screening. Eight people already knew they had coeliac disease. Overall, 1.17% of people in the clinic had coeliac disease (including both known and newly diagnosed cases), which is similar to rates seen in the general population.
  These findings show that routine screening in a fracture clinic identified very few new cases and is unlikely to be an effective way of finding undiagnosed coeliac disease
  

• REC name

  East Midlands - Leicester Central Research Ethics Committee

• REC reference

  23/EM/0058

• Date of REC Opinion

  17 May 2023

• REC opinion

  Further Information Favourable Opinion