Evidence map›Paper›PMID 25801315›Full record

ArticleJournal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research2015

Incident Vertebral Fractures and Risk Factors in the First Three Years Following Glucocorticoid Initiation Among Pediatric Patients With Rheumatic Disorders.

Claire M A LeBlanc, Jinhui Ma, Monica Taljaard, Johannes Roth, Rosie Scuccimarri, Paivi Miettunen, Bianca Lang, Adam M Huber, Kristin Houghton, Jacob L Jaremko and 18 more

Registry-linked trialOpen access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01663129 (Steroid-Induced Osteoporosis in the Pediatric Population - Canadian Incidence Study), which is not on this map. Cited by 52 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
52citing papers in PubMed, 1 pooled it
11.0field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01663129 completednot on this map

Steroid-Induced Osteoporosis in the Pediatric Population - Canadian Incidence Study (STOPP-CIS)

TypeobservationalSponsorChildren's Hospital of Eastern OntarioRan2005 to 2014Enrolled406ConditionsAcute Lymphoblastic Leukemia, Nephrotic Syndrome, Rheumatism
3 · Its place in the literature

Who cites it

52 citing papers in PubMed, 1 synthesis or guideline pooled it, 118 citations in OpenAlex.

  1. Pooled it
  2. Effect of Low-Magnitude Mechanical Stimuli on Bone Density and Structure in Pediatric Crohn's Disease: A Randomized Placebo-Controlled Trial.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2016
    Trial
  3. Review
  4. Approach to the Pediatric Patient With Glucocorticoid-Induced Osteoporosis.The Journal of clinical endocrinology and metabolism · 2025
    Article
  5. Article
  6. Article
  7. Article
  8. Article
  9. Article
  10. Article
  11. Article
  12. Article
  13. Article
  14. Risk factors associated with prevalent vertebral fractures in Duchenne muscular dystrophy.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2023
    Article
  15. Article
  16. Article
  17. Early-Onset Osteoporosis.Calcified tissue international · 2022
    Review
  18. Review
  19. Multiple vertebral compression fractures in a human immunodeficiency virus-positive patient with glucocorticoid-induced Cushing syndrome treated with percutaneous vertebroplasty: a case report.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2021
    Article
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

28 authors at 10 institutions in 1 country.

Claire M A LeBlancDepartment of Pediatrics, McGill University, Montreal, QC, Canada.
Jinhui MaSchool of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON, Canada.
Monica TaljaardSchool of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON, Canada.
Johannes RothDepartment of Pediatrics, University of Ottawa, Ottawa, ON, Canada.
Rosie ScuccimarriDepartment of Pediatrics, McGill University, Montreal, QC, Canada.
Paivi MiettunenDepartment of Pediatrics, University of Calgary, Calgary, AB, Canada.
Bianca LangDepartment of Pediatrics, Dalhousie University, Halifax, NS, Canada.
Adam M HuberDepartment of Pediatrics, Dalhousie University, Halifax, NS, Canada.
Kristin HoughtonDepartment of Pediatrics, University of British Columbia, Vancouver, BC, Canada.
Jacob L JaremkoDepartment of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, AB, Canada.
Josephine HoDepartment of Pediatrics, University of Calgary, Calgary, AB, Canada.
Nazih ShenoudaDepartment of Medical Imaging, University of Ottawa, Ottawa, ON, Canada.
Mary Ann MatzingerDepartment of Medical Imaging, University of Ottawa, Ottawa, ON, Canada.
Brian LentleDepartment of Radiology, University of British Columbia, Vancouver, BC, Canada.
Robert SteinDepartment of Pediatrics, University of Western Ontario, London, ON, Canada.
Anne Marie SbrocchiDepartment of Pediatrics, McGill University, Montreal, QC, Canada.
Kiem OenDepartment of Pediatrics, University of Manitoba, Winnipeg, MB, Canada.
Celia RoddDepartment of Pediatrics, University of Manitoba, Winnipeg, MB, Canada.
Roman JurencakDepartment of Pediatrics, University of Ottawa, Ottawa, ON, Canada.
Elizabeth A CummingsDepartment of Pediatrics, Dalhousie University, Halifax, NS, Canada.
Robert CouchDepartment of Pediatrics, University of Alberta, Edmonton, AB, Canada.
David A CabralDepartment of Pediatrics, University of British Columbia, Vancouver, BC, Canada.
Stephanie AtkinsonDepartment of Pediatrics, McMaster University, Hamilton, ON, Canada.
Nathalie AlosDepartment of Pediatrics, Université de Montréal, Montréal, QC, Canada.
Frank RauchDepartment of Pediatrics, McGill University, Montreal, QC, Canada.
Kerry SiminoskiDepartment of Radiology and Diagnostic Imaging, and Department of Medicine, University of Alberta, Edmonton, AB, Canada.
Leanne M WardDepartment of Pediatrics, University of Ottawa, Ottawa, ON, Canada.
Canadian STeroid-Associated Osteoporosis in Pediatric Population (STOPP) Consortium
University of Ottawa · CAMcGill University · CADalhousie University · CAUniversity of Alberta · CAUniversity of British Columbia · CAUniversity of Calgary · CAUniversity of Manitoba · CAMcMaster University · CAOttawa Public Health · CAWestern University · CA

Funding

CIHR 64285-1CIHR FRN 64285
6 · The paper itself

Abstract

Vertebral fractures are an important yet underrecognized manifestation of osteoporosis in children with chronic, glucocorticoid-treated illnesses. Our goal was to determine the incidence and clinical predictors of vertebral fractures in the 3 years following glucocorticoid initiation among pediatric patients with rheumatic disorders. Incident vertebral fractures were evaluated according to the Genant semiquantitative method on lateral radiographs at baseline and then annually in the 3 years following glucocorticoid initiation. Extended Cox models were used to assess the association between vertebral fractures and clinical risk predictors. A total of 134 children with rheumatic disorders were enrolled in the study (mean ± standard deviation (SD) age 9.9 ± 4.4 years; 65% girls). The unadjusted vertebral fracture incidence rate was 4.4 per 100 person-years, with a 3-year incidence proportion of 12.4%. The highest annual incidence occurred in the first year (6.0%; 95% confidence interval (CI) 2.9% to 11.7%). Almost one-half of the patients with fractures were asymptomatic. Every 0.5 mg/kg increase in average daily glucocorticoid (prednisone equivalents) dose was associated with a twofold increased fracture risk (hazard ratio (HR) 2.0; 95% CI 1.1 to 3.5). Other predictors of increased vertebral fracture risk included: (1) increases in disease severity scores between baseline and 12 months; (2) increases in body mass index Z-scores in the first 6 months of each 12-month period preceding the annual fracture assessment; and (3) decreases in lumbar spine bone mineral density Z-scores in the first 6 months of glucocorticoid therapy. As such, we observed that a clinically significant number of children with rheumatic disorders developed incident vertebral fractures in the 3 years following glucocorticoid initiation. Almost one-half of the children were asymptomatic and thereby would have been undiagnosed in the absence of radiographic monitoring. In addition, discrete clinical predictors of incident vertebral fractures were evident early in the course of glucocorticoid therapy.

Indexed as

AdolescentArthritis, JuvenileBone DensityChildCohort StudiesDermatomyositisFemaleGlucocorticoidsHumansIncidenceLupus Erythematosus, SystemicMaleOsteoporosisProportional Hazards ModelsRheumatic DiseasesRisk FactorsGlucocorticoidsADOLESCENTSBONE DENSITYCHILDRENGLUCOCORTICOIDSRHEUMATIC DISORDERSVERTEBRAL FRACTURES

Identifiers

PMID25801315
PMCPMC4556451
OpenAlexW2103884329

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.