Osteoporosis, bone & mineral

Corticosteroid Injections and Risk of Fracture

JAMA Netw OpenPublished Cohort study

Main finding · Fracture risk by cumulative CSI doseResult — go to the resultAdjusted hazard ratio 1.04 95% CI 0.96–1.11

Authors' conclusion

In this cohort study of cumulative injected corticosteroid dose and risk of subsequent fracture, no association was observed, including in patients with a preexisting diagnosis of osteoporosis.

Study context

Population
Adults receiving any CSI, May 1, 2018–July 1, 2022, residing in Olmsted County, Minnesota, empaneled for primary care within the Mayo Clinic346 (4.8%) new fractures
Participants
7,197 adults
Exposure
Risk of fracture by cumulative injected corticosteroid dose
Outcome
Risk of fracture by total triamcinolone equivalents received
Methodological detailsCox proportional hazards regression
  • Cox proportional hazards regression

Main finding

Fracture risk by cumulative CSI dose

Adjusted hazard ratio

1.04

95% CI 0.96–1.11

Cumulative CSI dose
aHR 1.04 (95% CI 0.96–1.11)

As reported in the abstract

Observational data: associations, not effects.

Secondary outcomes

Fracture risk by cumulative CSI dose, non-high-risk subgroup

aHR (95% CI)
Non-high-risk1.11 (0.98–1.26)

Fracture risk by cumulative CSI dose, osteoporosis subgroup

aHR (95% CI)
Osteoporosis1.01 (0.90–1.11)

Original publication

Corticosteroid Injections and Risk of Fracture. JAMA Netw Open. Published 1 May 2024. doi:10.1001/jamanetworkopen.2024.14316

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