Untangling fracture risk in monoclonal gammopathy of undetermined significance: A population‐based cohort study

Objective Monoclonal gammopathy of undetermined significance (MGUS) is the asymptomatic precursor of multiple myeloma (MM). Lytic bone lesions and fractures are hallmarks of MM and although there are no lytic lesions in MGUS, it has also been associated with fractures. The causes of fractures in MGUS are currently unclear but potential causes include inherent MGUS bone disease, undiagnosed MM, and peripheral neuropathy (PN). We therefore conducted a large population‐based study including 8395 individuals with MGUS and 30 851 matched controls from Sweden. Methods Data on fractures, PN, and confounders were acquired from high‐quality registers in Sweden. Results Monoclonal gammopathy of undetermined significance and PN were independently associated with fractures (hazard ratio [HR]: 1.29; 95% confidence interval [95% CI]: 1.21‐1.37; P