Patients treated with glucocorticoids may have fewer fractures vs patients with similar bone density
A recently presented study of patients in the northwest of England revealed fractures were less prevalent in patients treated with glucocorticoids compared to non-users with similar bone density.
Researchers studied data from 20,210 patients referred by primary or secondary providers for bone mineral density (BMD) estimation with dual X-ray absorptiometry of the spine based on the mean density of the L1 to L4 vertebrae and femoral neck. Patients had a mean age of 63.2 years and 82% women. Overall, 32% of patients had a history of fracture and 3,772 (19%) received glucocorticoids (GCs) at the time of referral. Patients who received GCs had a mean age similar to that of untreated patients.
Fewer patients treated with GCs had a history of fracture compared with untreated patients (13% vs. 22%). Investigators found 19.5% of patients treated with GCs had been prescribed antiresorptive agents compared with 7.2% of untreated patients.
Patients who received GCs had higher BMD at both locations with 1.09 g/cm2 in the lumbar spine compared with 1.04 g/cm2 in untreated patients, and both groups had a mean density of 0.9 g/cm2 in the femoral neck. Patients who received antiresorptive agents had a similar risk for fractures compared with patients who did not, and investigators found similar results after adjusting for hip or spinal BMD.
“The surprising, apparently protective effects of GC on bone quality from this large cross-sectional study cannot be explained by known confounding factors,” the researchers wrote. “These results are likely subject to unmeasured confounding and need to be interpreted with caution.” - by Shirley Pulawski
Bukhari M, et al. Paper #373. Presented at: American College of Rheumatology Annual Meeting; Nov. 7-11, 2015; San Francisco.
Disclosures: The researchers report no relevant financial disclosures.