ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2017
Use of systemic glucocorticoids and the risk of major osteoporotic fractures in patients with sarcoidosis.
Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 23 citations in OpenAlex.
- Sarcoidosis with musculoskeletal manifestations: systematic review of non-pharmacological and pharmacological treatments.Rheumatology international · 2022Pooled it
- Review
- Osteoporotic bone fracture risk assessment in Latvian patients with newly diagnosed sarcoidosis.Sarcoidosis, vasculitis, and diffuse lung diseases : official journal of WASOG · 2024Article
- Imaging Plays a Key Role in the Diagnosis and Control of the Treatment of Bone Sarcoidosis.Biomedicines · 2023Review
- The Risk of Sarcoidosis Misdiagnosis and the Harmful Effect of Corticosteroids When the Disease Picture Is Incomplete.Biomedicines · 2023Review
- Safety of corticosteroid therapy in sarcoidosis treatment.Frontiers in drug safety and regulation · 2023Review
- Bone fragility and sarcoidosis: An underestimated relationship.Frontiers in medicine · 2022Article
- Association between Irritable Bowel Syndrome and Risk of Osteoporosis in Korean Premenopausal Women.Medical principles and practice : international journal of the Kuwait University, Health Science Centre · 2021Article
- Bone Mineral Loss and Fracture in Sarcoidosis: A Systematic Review and Meta-Analysis.Archives of rheumatology · 2019Article
- Glucocorticoids suppress Wnt16 expression in osteoblasts in vitro and in vivo.Scientific reports · 2018Article
- Sarcoidosis and calcium homeostasis disturbances-Do we know where we stand?Chronic respiratory diseaseReview
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Authors and funding
9 authors at 6 institutions in 4 countries.
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No grant is acknowledged in the PubMed record.
Abstract
This study revealed the risk of major osteoporotic fracture in patients with sarcoidosis exposed to glucocorticoids. Current use of glucocorticoids was associated with a risk of fracture, with no difference between patients with and without sarcoidosis. Sarcoidosis per se was not associated with an increased fracture risk.
introductionSarcoidosis is a multi-organ, chronic inflammatory, granulomatous disorder that most frequently affects the lungs, lymph nodes, skin, eyes, and liver, but may occur in any organ, including the bones. While oral glucocorticoids (GCs) are commonly used as initial treatment, little is known about the risk of major osteoporotic fractures in patients with sarcoidosis exposed to GCs.
methodsA case-control study was conducted using the Danish National Hospital Discharge Registry (NHDR) between January 1995 and December 2011. Conditional logistics regression models were used to derive adjusted odds ratios (OR) of major osteoporotic fractures in subjects with and without sarcoidosis stratified by average daily and cumulative dose exposures.
resultsA total of 376,858 subjects with a major osteoporotic fracture and the same number of subjects without this event were identified (mean age 64.2 ± 19.5 years, 69% female). In patients with sarcoidosis (n = 124), current use of GC was associated with an increased risk of major osteoporotic fracture (adjusted (adj.) OR 1.74; 95% CI 1.17-2.58), which dropped to baseline levels after discontinuation. In subjects without sarcoidosis, this risk was comparable (adj. OR 1.36; 95% CI 1.32-1.40). In sarcoidosis patients, cumulative dose 1.0-4.9 g and >10 g prednisolone equivalents were associated with increased risk of major osteoporotic fracture (adj. OR 2.75; 95% CI 1.06-7.14 and 2.22; 95% CI 1.17-4.22, respectively), whereas a cumulative dose of <1.0 g and 5.0-9.9 g was not associated with major osteoporotic fracture risk.
conclusionBoth in subjects with and without sarcoidosis, current expose to GC is associated with increased risk of major osteoporotic fractures, with no between-group difference. Sarcoidosis per se was not associated with increased fracture risk. Having sarcoidosis per se, i.e., if not treated with GC, is not a risk factor for fracture, and such patients may only need risk assessment when they commence GC therapy.
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