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Fracture Risk with Low Dose Steroid

Jul 22, 2021 4:41 pm

A large RA cohort analysis shows that low-dose glucocorticoid therapy in rheumatoid arthritis (RA) patients may carry an increased risk of vertebral osteoporotic (OP) fractures. 

There were 15,123 RA patients (mean age 68.8 years) enrolled in Clinical Practice Research Datalink between 1997–2017. Groups were stratified by glucocorticoids dose, duration of use and subsequent risk of incident osteoporotic fractures (hip, vertebrae, humerus, forearm, pelvis, and ribs).

A total of 1640 osteoporotic fractures occurred.

Current low-dose oral steroids (≤7.5 mg prednisolone equivalent/day) was not associated with an increased risk of OP fractures (adjusted hazard ratio 1.14, 95% CI 0.98–1.33) compared with past glucocorticoid use; but was associated with an increased risk of vertebral fracture (adj HR1.59, 95% CI 1.11–2.29).

Results were unaffected by short-term or a long-term use of glucocorticoids.

Even low daily doses of glucocorticoid may translate to an increased risk of vertebral fracture in RA patients.

The author has no conflicts of interest to disclose related to this subject

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