Bone density threshold and other predictors of vertebral fracture in patients receiving oral glucocorticoid therapy.

摘要: OBJECTIVE: To evaluate predictors of vertebral fractures, including a threshold for bone mineral density (BMD), in patients receiving oral glucocorticoids (GCs). METHODS: Data were obtained from 2 randomized clinical trials (prevention and treatment risedronate) using similar methods, but different inclusion criteria applied with regard to prior exposure GCs. Predictors fracture the placebo group identified Cox regression forward selection. The BMD analysis involved comparison 1-year risk postmenopausal women GC that not taking GCs 3 other trials. RESULTS: study population comprised 306 baseline followup data on fractures (111 195 risedronate). In group, statistically significant incident lumbar spine (for each 1-point decrease T score, relative [RR] 1.85, 95% confidence interval [95% CI] 1.06-3.21) daily dose 10-mg increase, RR 1.62, CI 1.11-2.36). analysis, compared nonusers GCs, younger, had higher at baseline, fewer prevalent fractures; nevertheless, was users (adjusted 5.67, 2.57-12.54). increased observed regardless whether osteoporosis present. CONCLUSION: daily, cumulative, found be strong predictor At levels BMD, as considerably risks fracture.