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|Title: ||Use of systemic glucocorticoids and the risk of major osteoporotic fractures in patients with sarcoidosis|
|Authors: ||Oshagbemi, O. A.|
Driessen, J. H. M.
Wouters, E. F. M.
Van den Bergh, Jan
Franssen, F. M. E.
de Vries, F.
|Issue Date: ||2017|
|Publisher: ||SPRINGER LONDON LTD|
|Citation: ||OSTEOPOROSIS INTERNATIONAL, 28(10), p. 2859-2866|
|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. Introduction Sarcoidosis 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. Methods A 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. Results A 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. Conclusion Both 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.|
|Notes: ||[Oshagbemi, O. A.; Driessen, J. H. M.; de Vries, F.] Maastricht Univ, Med Ctr, Dept Clin Pharm & Toxicol, Maastricht, Netherlands. [Oshagbemi, O. A.; Driessen, J. H. M.; de Vries, F.] Utrecht Inst Pharmaceut Sci, Dept Pharmacoepidemiol & Clin Pharmacol, Utrecht, Netherlands. [Oshagbemi, O. A.; Driessen, J. H. M.; de Vries, F.] Care & Publ Hlth Res Inst CAPHRI, Maastricht, Netherlands. [Driessen, J. H. M.; van den Bergh, J.] Maastricht Univ, Med Ctr, Res Sch NUTRIM, Maastricht, Netherlands. [Pieffers, A.] Antonius Hosp, Dept Clin Pharm, Sneek, Netherlands. [Wouters, E. F. M.; Franssen, F. M. E.] CIRO, Dept Res & Educ, Horn, Netherlands. [Wouters, E. F. M.; Franssen, F. M. E.] MUMC, Dept Resp Med, Maastricht, Netherlands. [Geusens, P.] Hasselt Univ, Biomed Res Inst, Hasselt, Belgium. [Geusens, P.; van den Bergh, J.] MUMC, Dept Internal Med, Subdiv Rheumatol, Maastricht, Netherlands. [Vestergaard, P.] Aarhus Univ Hosp, Dept Endocrinol & Internal Med MEA, Aarhus, Denmark. [van den Bergh, J.] Viecuri MC Venlo, Dept Internal Med, Venlo, Netherlands. [de Vries, F.] Southampton Gen Hosp, MRC Lifecourse Epidemiol Unit, Southampton, Hants, England.|
|ISI #: ||000412164400012|
|Type: ||Journal Contribution|
|Appears in Collections: ||Research publications|
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