Bone density threshold and other predictors of vertebral fracture in patients receiving oral glucocorticoid therapy

• DOI: 10.1002/art.11283
• Publication Date: 2003-11-07T10:01:05Z
• Authors: T. P. Van Staa; R. F. Laan; I. P. Barton; S. Cohen; D. M. Reid; C. Cooper
• Keywords: Adult; Male; Risk; UMCN 4.2: Chronic inflammation and autoimmunity; Adolescent; 610; Administration, Oral; 03 medical and health sciences; Absorptiometry, Photon; 0302 clinical medicine; Double-Blind Method; Bone Density; Risk Factors; Humans; Glucocorticoids; Osteoporosis, Postmenopausal; Aged; Aged, 80 and over; Lumbar Vertebrae; Femur Neck; Middle Aged; 3. Good health; Postmenopause; Prednisone; Female

Abstract Objective To evaluate predictors of vertebral fractures, including a threshold for bone mineral density (BMD), in patients receiving oral glucocorticoids (GCs). Methods Data were obtained from 2 randomized clinical trials (prevention and treatment risedronate) using similar methods, but different inclusion criteria applied with regard to prior exposure GCs. Predictors fracture the placebo group identified Cox regression forward selection. The BMD analysis involved comparison 1‐year risk postmenopausal women GC that not taking GCs 3 other trials. Results study population comprised 306 baseline followup data on fractures (111 195 risedronate). In group, statistically significant incident lumbar spine (for each 1‐point decrease T score, relative [RR] 1.85, 95% confidence interval [95% CI] 1.06–3.21) daily dose 10‐mg increase, RR 1.62, CI 1.11–2.36). analysis, compared nonusers GCs, younger, had higher at baseline, fewer prevalent fractures; nevertheless, was users (adjusted 5.67, 2.57–12.54). increased observed regardless whether osteoporosis present. Conclusion daily, cumulative, found be strong predictor At levels BMD, as considerably risks fracture.