Rapid reduction in fracture risk after the discontinuation of long-term oral glucocorticoid therapy: a retrospective cohort study using a nationwide health insurance claims database in Japan
Authors' conclusion
Fracture risk declines rapidly in the first year after GC discontinuation, but vigilance is necessary as the increased risk persists for two years post-discontinuation.
Study context
- Population
- Patients aged ≥ 50 years who initiated GC therapy in 2012–2019, Japanwomen and men analysed separately
- Exposure
- GC discontinuation vs GC continuation and vs reference
- Outcome
- Incidence of hip and clinical vertebral fractures after GC discontinuation (adjusted HRs)
- Follow-up
- Up to 990 days
Methodological detailsnationwide health insurance claims database (NDBJ), inverse probability weighting using propensity scores for GC discontinuation
- Nationwide health insurance claims database (NDBJ)
- Inverse probability weighting using propensity scores for GC discontinuation
Main finding
As reported in the abstract
Fracture incidence, GC-discontinuation vs GC-continuation · initial 90 days to 360 days after GC discontinuation
| Group | n women | n men |
|---|---|---|
| GC-discontinuation | 52,179 | 57,560 |
| GC-continuation | 91,969 | 93,736 |
| Reference | 43,138 | 33,696 |
n women
GC-discontinuation52,179
GC-continuation91,969
Reference43,138
n men
GC-discontinuation57,560
GC-continuation93,736
Reference33,696
Observational data: associations, not effects.
Further findings
- HRs for hip fracture remained significantly higher in GC-discontinuation vs reference for 720 days post-discontinuation
Original publication
Rapid reduction in fracture risk after the discontinuation of long-term oral glucocorticoid therapy: a retrospective cohort study using a nationwide health insurance claims database in Japan. Osteoporos Int. Published 21 October 2024. doi:10. 1007/ s00198-024-07284-1
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