Low-dose oral glucocorticoid therapy and risk of osteoporotic fractures in patients with rheumatoid arthritis: a cohort study using the Clinical Practice Research Datalink
| العنوان: | Low-dose oral glucocorticoid therapy and risk of osteoporotic fractures in patients with rheumatoid arthritis: a cohort study using the Clinical Practice Research Datalink |
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| المؤلفون: | Joop P. W. van den Bergh, Shahab Abtahi, Tjeerd van Staa, Johanna H M Driessen, Patrick C. Souverein, Andrea M. Burden, Annelies Boonen, Frank de Vries |
| المساهمون: | RS: CAPHRI - R5 - Optimising Patient Care, Clinical Pharmacy, RS: Carim - V01 Vascular complications of diabetes and metabolic syndrome, RS: NUTRIM - R3 - Respiratory & Age-related Health, Interne Geneeskunde, MUMC+: MA Reumatologie (9), RS: CAPHRI - R3 - Functioning, Participating and Rehabilitation, MUMC+: DA KFT Medische Staf (9), Driessen, Johanna/0000-0002-4503-6408, de Vries, Frank/0000-0003-3837-8319, Abtahi, Shahab/0000-0003-0482-5563, Abtahi, Shahab, Driessen, Johanna H. M., Burden, Andrea M., Souverein, Patrick C., VAN DEN BERGH, Joop, van Staa, Tjeerd P., Boonen , Annelies, de Vries , Frank |
| المصدر: | Rheumatology, 61(4), 1448-1458. Oxford University Press Rheumatology, 61 (4) |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Male, medicine.medical_specialty, CORTICOSTEROIDS, PREDNISOLONE, VALIDATION, Arthritis, Rheumatoid, Cohort Studies, Rheumatology, Forearm, BMD, Risk Factors, Internal medicine, medicine, EPIDEMIOLOGY, Humans, Pharmacology (medical), Glucocorticoids, Pelvis, POPULATION, Aged, business.industry, Hazard ratio, medicine.disease, Clinical trial, medicine.anatomical_structure, Rheumatoid arthritis, Prednisolone, Spinal Fractures, Female, business, RA, Glucocorticoid, Osteoporotic Fractures, Cohort study, medicine.drug |
| الوصف: | Objectives: Clinical trials have shown that low-dose glucocorticoid therapy in patients with rheumatoid arthritis (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. Methods: This was a cohort study including patients with RA aged 50+ years from the Clinical Practice Research Datalink between 1997-2017. Exposure to oral glucocorticoids was stratified by the most recent prescription in current (1 year) use, and average daily and cumulative doses. Risk of incident osteoporotic fractures (including hip, vertebrae, humerus, forearm, pelvis, and ribs) were estimated by time-dependent Cox proportional-hazards models, adjusted for life-style parameters, comorbidities, and comedications. Secondary analyses assessed osteoporotic fracture risk with a combination of average daily and cumulative doses of oral glucocorticoids. Results: Among 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/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. Rheumatology, 61 (4) |
| وصف الملف: | text; application/application/pdf; application/pdf |
| تدمد: | 1462-0332 1462-0324 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::b9dd7bb09e5a20e8a3e3ac62f0960081Test https://pubmed.ncbi.nlm.nih.gov/34255815Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....b9dd7bb09e5a20e8a3e3ac62f0960081 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14620332 14620324 |
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