ArticleRheumatology (Oxford, England)2022
Low-dose oral glucocorticoid therapy and risk of osteoporotic fractures in patients with rheumatoid arthritis: a cohort study using the Clinical Practice Research Datalink.
Article in Rheumatology (Oxford, England), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.
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Who cites it
22 citing papers in PubMed, 2 syntheses or guidelines pooled it, 35 citations in OpenAlex.
- Pooled it
- Meta-analysis of the efficacy and safety of vamorolone in Duchenne muscular dystrophy.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Pooled it
- Associations of allergic diseases with incident hospital-recorded osteoporosis and major osteoporotic fracture in older adults: a prospective cohort study in the UK Biobank.BMC geriatrics · 2026Article
- Different durations of arthritis and hip fracture risk among middle-aged and older adults evidence from CHARLS 2011-2020.Clinical rheumatology · 2026Article
- Incidence and risk factors of subsequent vertebral fracture following percutaneous vertebral augmentation in postmenopausal women.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- Early Identification of Cardiovascular Adverse Events Associated With Rofecoxib Using Real-World Data From the UK: A Nested Case-Control and Case-Crossover Study.Pharmacoepidemiology and drug safety · 2026Article
- Development and progression of hepatic steatosis during long-term glucocorticoid therapy in autoimmune hepatitis: multimodal evidence from biopsy, CAP, and ultrasound.Frontiers in medicine · 2026Article
- The impact of aging and glucocorticoid use on physical function of older rheumatoid arthritis in remission: analysis of a National Database of Rheumatic Disease in Japan.Clinical rheumatology · 2025Article
- Article
- Management of Late-Onset Rheumatoid Arthritis with Treat-to-Target Strategy.Drugs & aging · 2025Review
- Article
- ["Paradoxical fractures": pathological fractures under anti-osteoporotic and antirheumatic treatment].Zeitschrift fur Rheumatologie · 2025Review
- Hormonal interventions in skin wounds - a mini review.Molecular medicine (Cambridge, Mass.) · 2024Review
- Low-Dose Glucocorticoids in Older Patients with Rheumatoid Arthritis: What Does the Evidence Say?Drugs & aging · 2024Review
- Damaged bone microarchitecture by Trabecular Bone Score (TBS) and low appendicular muscle mass: main risk factors for vertebral and non-vertebral fractures in women with long-standing rheumatoid arthritis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2024Article
- Systemic glucocorticoid exposure and postoperative infection risk in 143,782 appendectomy patients-a Danish longitudinal nationwide study.Langenbeck's archives of surgery · 2024Article
- Luobitong Potentiates MTX's Anti-Rheumatoid Arthritis Activity via Targeting Multiple Inflammatory Pathways.Journal of inflammation research · 2024Article
- Safety of corticosteroid therapy in sarcoidosis treatment.Frontiers in drug safety and regulation · 2023Review
- Personalized Therapeutic Strategies in the Management of Osteoporosis in Patients with Autoantibody-Positive Rheumatoid Arthritis.Journal of clinical medicine · 2022Review
- The Impact of High Dose Glucocorticoids on Bone Health and Fracture Risk in Systemic Vasculitides.Frontiers in endocrinology · 2022Review
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesClinical trials have shown that low-dose glucocorticoid therapy in patients with RA reduces bone loss in hands or hip, but the effect on osteoporotic fractures is not yet clear. Therefore, we investigated the use of low-dose oral glucocorticoids and risk of osteoporotic fractures among patients with RA.
methodsThis was a cohort study including patients with RA aged 50+ years from the Clinical Practice Research Datalink between 1997 and 2017. Exposure to oral glucocorticoids was stratified by the most recent prescription in current (<6 months), recent (7-12 months) and past (>1 year) use, and average daily and cumulative doses. Risk of incident osteoporotic fractures (including hip, vertebrae, humerus, forearm, pelvis and ribs) was estimated by time-dependent Cox proportional-hazards models, adjusted for lifestyle parameters, comorbidities and comedications. Secondary analyses assessed osteoporotic fracture risk with a combination of average daily and cumulative doses of oral glucocorticoids.
resultsAmong 15 123 patients with RA (mean age 68.8 years, 68% females), 1640 osteoporotic fractures occurred. Current low-dose oral glucocorticoid therapy (≤7.5 mg prednisolone equivalent dose/day) in patients with RA was not associated with overall risk of osteoporotic fractures (adjusted hazard ratio 1.14, 95% CI 0.98, 1.33) compared with past glucocorticoid use, but was associated with an increased risk of clinical vertebral fracture (adjusted hazard ratio 1.59, 95% CI 1.11, 2.29). Results remained unchanged regardless of a short-term or a long-term use of oral glucocorticoids.
conclusionClinicians should be aware that even in RA patients who receive low daily glucocorticoid doses, the risk of clinical vertebral fracture is increased.
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