Tags

Type your tag names separated by a space and hit enter

Fracture risk associated with systemic and topical corticosteroids.
J Intern Med 2005; 257(4):374-84JI

Abstract

OBJECTIVES

To study the fracture risk associated with the use of corticosteroids in any formulation and administration.

DESIGN

Case-control study.

SETTING

Community-based study in Denmark. Subjects. Cases were all subjects with any fracture sustained during the year 2000 (n = 124,655). For each case, three controls (n = 373,962) matched on age and gender were randomly drawn from the background population. Adjustments were made for concurrent diseases (lung diseases, rheumatic disorders), use of other drugs (inhaled bronchodilators), contacts to hospitals and general practitioners, and social variables.

RESULTS

An increased risk of any fracture, hip, spine, and forearm fractures was present with use of more than 2.5 mg of prednisolone or equivalent orally per day. For inhaled corticosteroids a limited increase in the risk of any fracture was present in users of more than 7.5 mg prednisolone equivalents per day (equivalent to 1875 mug of budesonide per day). However, no increase in the risk of hip, spine or forearm fractures was present in users of inhaled corticosteroids. For other topical corticosteroids (dermal, rectal, nasal, local application in the mouth, the eyes or the ears) no increase in fracture risk could be demonstrated even at high doses after adjustment for confounders.

CONCLUSIONS

Ingestion of more than 2.5 mg of oral prednisolone equivalents per day is associated with an increase in fracture risk. No increase is associated with inhaled corticosteroids except at daily dosages above 7.5 mg of prednisolone equivalents. No increase in fracture risk is associated with other forms of topical corticosteroids.

Authors+Show Affiliations

Department of Endocrinology and Metabolism C, Aarhus University Hospital, Aarhus, Denmark. p-vest@post4.tele.dkNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15788008

Citation

Vestergaard, P, et al. "Fracture Risk Associated With Systemic and Topical Corticosteroids." Journal of Internal Medicine, vol. 257, no. 4, 2005, pp. 374-84.
Vestergaard P, Rejnmark L, Mosekilde L. Fracture risk associated with systemic and topical corticosteroids. J Intern Med. 2005;257(4):374-84.
Vestergaard, P., Rejnmark, L., & Mosekilde, L. (2005). Fracture risk associated with systemic and topical corticosteroids. Journal of Internal Medicine, 257(4), pp. 374-84.
Vestergaard P, Rejnmark L, Mosekilde L. Fracture Risk Associated With Systemic and Topical Corticosteroids. J Intern Med. 2005;257(4):374-84. PubMed PMID: 15788008.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fracture risk associated with systemic and topical corticosteroids. AU - Vestergaard,P, AU - Rejnmark,L, AU - Mosekilde,L, PY - 2005/3/25/pubmed PY - 2005/5/6/medline PY - 2005/3/25/entrez SP - 374 EP - 84 JF - Journal of internal medicine JO - J. Intern. Med. VL - 257 IS - 4 N2 - OBJECTIVES: To study the fracture risk associated with the use of corticosteroids in any formulation and administration. DESIGN: Case-control study. SETTING: Community-based study in Denmark. Subjects. Cases were all subjects with any fracture sustained during the year 2000 (n = 124,655). For each case, three controls (n = 373,962) matched on age and gender were randomly drawn from the background population. Adjustments were made for concurrent diseases (lung diseases, rheumatic disorders), use of other drugs (inhaled bronchodilators), contacts to hospitals and general practitioners, and social variables. RESULTS: An increased risk of any fracture, hip, spine, and forearm fractures was present with use of more than 2.5 mg of prednisolone or equivalent orally per day. For inhaled corticosteroids a limited increase in the risk of any fracture was present in users of more than 7.5 mg prednisolone equivalents per day (equivalent to 1875 mug of budesonide per day). However, no increase in the risk of hip, spine or forearm fractures was present in users of inhaled corticosteroids. For other topical corticosteroids (dermal, rectal, nasal, local application in the mouth, the eyes or the ears) no increase in fracture risk could be demonstrated even at high doses after adjustment for confounders. CONCLUSIONS: Ingestion of more than 2.5 mg of oral prednisolone equivalents per day is associated with an increase in fracture risk. No increase is associated with inhaled corticosteroids except at daily dosages above 7.5 mg of prednisolone equivalents. No increase in fracture risk is associated with other forms of topical corticosteroids. SN - 0954-6820 UR - https://www.unboundmedicine.com/medline/citation/15788008/Fracture_risk_associated_with_systemic_and_topical_corticosteroids_ L2 - https://doi.org/10.1111/j.1365-2796.2005.01467.x DB - PRIME DP - Unbound Medicine ER -