Average daily glucocorticoid dose, number of prescription days, and cumulative dose in the initial 90 days of glucocorticoid therapy are associated with subsequent hip and clinical vertebral fracture risk: a retrospective cohort study using a nationwide health insurance claims database in Japan
Authors' conclusion
GC exposure in the initial 90 days of GC therapy was dose-dependently associated with hip and clinical vertebral fracture risk.
Study context
- Population
- Patients aged ≥ 50 years in the nationwide health insurance claims database of Japan
- Exposure
- Glucocorticoid (GC) exposure in the initial 90 days of GC therapy vs reference group
- Outcome
- Hip and clinical vertebral fracture
- Follow-up
- Subsequent 1080 days
Methodological detailsnationwide health insurance claims database (NDBJ), Cox regression adjusted for potential confounders
- Nationwide health insurance claims database (NDBJ)
- Cox regression adjusted for potential confounders
Main finding
As reported in the abstract
- Higher GC doses and longer prescription days in the initial 90 days significantly and dose-dependently associated with increased fracture risk vs reference
- GC ≥ 5 mg PSL/day: significantly increased fracture risk in the stratum of 30-59 days of GC prescription
Observational data: associations, not effects.
Further findings
Fracture risk in women receiving GC ≥ 1 and < 2.5 mg PSL/day for 90 days (subgroup)
- Significantly increased fracture risk
Original publication
Average daily glucocorticoid dose, number of prescription days, and cumulative dose in the initial 90 days of glucocorticoid therapy are associated with subsequent hip and clinical vertebral fracture risk: a retrospective cohort study using a nationwide health insurance claims database in Japan. Osteoporos Int. Published 24 January 2024. doi:10. 1007/ s00198-024-07023-6
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