Glucocorticoid-related osteoporotic fractures

This study was conducted to evaluate the prevalence of fractures secondary to steroid use.

A total of 165 patients (100 male and 65 female) who received glucocorticoid therapy at a dose of 7.5 mg or more, or its equivalent, for more than six months were identified from July 1, 2007 to December 30, 2007. Data extracted included age, gender, dose of glucocorticoid, concomitant diseases, the use of anti-resorptive therapy, calcium and vitamin D supplementation, and the results of bone mineral density (BMD) tests, if performed. Any fragility fractures, the site involved and the treatment administered were also recorded. The data was entered and analysed using the Statistical Package for the Social Sciences.

140 patients had no fractures while 25 (15.2 percent) sustained an osteoporotic fracture. The age (p-value less than 0.5), dose of steroids (p-value less than 0.001) and duration of glucocorticoid therapy (p-value less than 0.001) were significantly higher among patients who sustained fractures. Of these, 12 were male and 13 were female. None of the patients in both groups was started on antiresorptive therapy. The dosage of glucocorticoids was higher among women than men (11.5 versus 24.5 mg/day, p-value is 0.05). The commonest sites of osteoporotic fracture were the spine (44 percent) and proximal femur (24 percent). Eight out of 11 patients had more than one vertebra involved.

Fractures due to steroid-induced osteoporosis could have been prevented if appropriate measures were taken.