Evidence map›Paper›PMID 27651928›Full record

ArticleRMD open2016

One-year effects of glucocorticoids on bone density: a meta-analysis in cohorts on high and low-dose therapy.

Willem F Lems, Merel M E Baak, Lilian H D van Tuyl, Mariëtte C Lodder, Ben A C Dijkmans, Maarten Boers

Open access · goldAbstract read
In one paragraph

Article in RMD open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
2.2field-weighted citation impact, top 13% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.

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  5. Observational
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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

6 authors at 2 institutions in 1 country.

Willem F LemsAmsterdam Rheumatology and immunology Center, VUmc, Amsterdam , The Netherlands.
Merel M E BaakAmsterdam Rheumatology and immunology Center, VUmc, Amsterdam , The Netherlands.
Lilian H D van TuylAmsterdam Rheumatology and immunology Center, VUmc, Amsterdam , The Netherlands.
Mariëtte C LodderDepartment of Rheumatology , Spaarne Gasthuis , Haarlem , The Netherlands.
Ben A C DijkmansAmsterdam Rheumatology and immunology Center, VUmc, Amsterdam , The Netherlands.
Maarten BoersAmsterdam Rheumatology and immunology Center, VUmc,Amsterdam, The Netherlands; Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam,The Netherlands.
Amsterdam UMC Location VUmc · NLSpaarne Gasthuis · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBone loss during glucocorticoid (GC) therapy is poorly quantified.

objectiveQuantification of bone loss in GC-treated patients with chronic inflammatory diseases (CID; low dose) and transplants (high dose).

methodsMeta-analysis of cohorts: PubMed, Cochrane, EMBASE and bibliographic searches (1995-2012). Eligible studies prospectively included GC-treated patients with two dual X-ray absorptiometry measurements of spine or hip over a period of at least 12 months. Only supplementation with calcium or vitamin D3 was allowed. 5602 titles yielded 285 articles: 51 study arms in CID (N=1565), 18 study arms in transplantation (N=571). Prednisone-equivalent GC doses and inverse variance weighted mean bone changes were used in a random effects model.

resultsIn CID, the mean GC dose was 8.7 mg/day (range 1.2-16.4). The mean 1-year bone loss in the lumbar spine was -1.7% (95% CI -2.2% to -1.2%); in the femoral neck: -1.3 (-1.8 to -0.7). In transplantation, the mean GC dose was 18.9 mg/day (range 6.0-52.7). Bone loss in the lumbar spine was -3.6% (-5.2% to -2.0%); in the femoral neck: -3.1% (-5.1% to -1.1%). Within the two groups, bone loss was not related to GC dose.

conclusionIn CID, GC-related bone loss appears limited and manageable if current anti-osteoporotic strategies are fully implemented. In transplantation, and probably also other high-dose settings, bone loss is considerable and represents unmet need. The heterogeneity probably reflects the important influence of other factors, most notably the underlying disease and the efficacy of GC treatment.

Indexed as

Bone Mineral DensityCorticosteroidsRheumatoid Arthritis

Identifiers

PMID27651928
PMCPMC5020666
OpenAlexW2520668663

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

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.