Very high frequency of fragility fractures associated with high-dose glucocorticoids in postmenopausal women: A retrospective study.
Very high frequency of fragility fractures associated with high-dose glucocorticoids in postmenopausal women: A retrospective study.
复制标题
DOI：
10.1016/j.bonr.2016.11.003
复制
发表时间：
2017-06
期刊：
影响因子：
2.5
通讯作者：
Morinobu A
中科院分区：
文献类型：
--
作者：
Kageyama G;Okano T;Yamamoto Y;Nishimura K;Sugiyama D;Saegusa J;Tsuji G;Kumagai S;Morinobu A
目的探讨大剂量糖皮质激素治疗全身性风湿病患者后脆性骨折的发生率。研究方法：对1988年4月至2012年3月在科比大学医院接受大剂量泼尼松龙（> 0.8 mg/kg）治疗全身性风湿病的患者进行的回顾性研究。主要结局是大剂量糖皮质激素治疗后的严重骨质疏松性骨折（定义为临床椎骨、髋部、前臂或肱骨近端骨折）。对于年龄超过40岁的绝经后女性和男性，通过世界卫生组织的骨折风险评估工具（FRAX®）评估患者在开始高剂量糖皮质激素治疗时的骨折风险。结果229例患者（中位年龄：49岁）中，57例在观察期内发生脆性骨折（中位观察期：1558天）。84例绝经前患者中，5例发生骨折。相反，在86名绝经后女性中，36名发生骨折。脆性骨折的发生率远高于FRAX®评分预测的发生率。FRAX®评分超过8.3%的患者骨折风险特别高。结论与大剂量糖皮质激素治疗相关的脆性骨折在绝经后妇女中很常见。特别是绝经后妇女，当需要大剂量糖皮质激素治疗时，应格外小心。我们评估了与大剂量糖皮质激素治疗相关的脆性骨折的发生率。在86名绝经后女性中，36名在观察期间发生骨折。FRAX评分超过8.3%的患者骨折风险特别高。
Purpose To evaluate the incidence of fragility fractures associated with high-dose glucocorticoid therapy in patients with systemic rheumatic disease. Methods: A retrospective study of patients who were treated with high-dose prednisolone (> 0.8 mg/kg) for systemic rheumatic disease at Kobe University Hospital from April 1988 to March 2012. The primary outcome was a major osteoporotic fracture (defined as a clinical vertebral, hip, forearm, or proximal humerus fracture) after high-dose glucocorticoid therapy. For postmenopausal women and men over 40 of age, the patient's fracture risk at the beginning of high-dose glucocorticoid therapy was assessed by the World Health Organization's Fracture Risk Assessment Tool (FRAX®). Results Of 229 patients (median age: 49 years), 57 suffered a fragility fracture during the observation period (median observation period: 1558 days). Of 84 premenopausal patients, 5 suffered a fracture. In contrast, of 86 postmenopausal female, 36 suffered a fracture. Fragility fractures were far more frequent than predicted by the FRAX® score. Patients with FRAX® scores over 8.3% had a particularly high risk of fracture. Conclusions Fragility fractures associated with high-dose glucocorticoid therapy are common among postmenopausal women. Extreme care should be taken especially for postmenopausal women when high-dose glucocorticoid therapy is required. We evaluated the incidence of the fragility fractures associated with high-dose glucocorticoid therapy. Of 86 postmenopausal female, 36 suffered a fracture during the observation period. Patients with FRAX scores over 8.3% had a particularly high risk of fracture.