皮质类固醇注射和骨折风险
Terin T Sytsma1, Shannon Thomas2, Karen M Fischer3
1Division of Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, Rochester, Minnesota.
JAMA network open
|May 31, 2024
概括
皮质类固醇注射 (CSI) 不会增加骨折风险,即使在患有骨质疏松症的患者中也是如此. 临床医生可以自信地使用CSI来缓解疼痛,而不必担心骨健康并发症.
科学领域:
- 肌肉骨健康 肌肉骨健康
- 骨的新陈代谢 骨的新陈代谢
- 药理学 药理学是指药理学的学科.
背景情况:
- 皮质类固醇注射 (CSI) 广泛用于肌肉骨疼痛缓解.
- 骨损伤对骨健康和骨折风险的长度影响仍然不清楚.
研究的目的:
- 为了研究累积的皮质类固醇注射剂量与随后的骨折风险之间的关联.
- 评估接受CSI的骨质疏松症和没有骨质疏松症患者的骨折风险.
主要方法:
- 在2018年5月至2022年7月期间接受CSI的7197名成年患者的队列研究.
- 考克斯的比例危险回归模型分析骨折风险基于累计的CSI剂量 (triamcinolone等价物).
- 小组分析包括没有高骨折风险的患者和患有骨质疏松症的患者.
主要成果:
- 较高的累积CSI剂量和骨折风险增加之间没有发现任何关联 (调整HR,1.04).
- 这种缺乏关联对于不处于高风险的患者 (调整HR,1.11) 和患有骨质疏松症的患者 (调整HR,1.01) 的子组是正确的.
- 年龄,查尔森并发症指数和先前的骨折是骨折的重要危险因素.
结论:
- 累积的皮质类固醇注射剂量与随后骨折的风险增加无关.
- 对疼痛疾病的CSI治疗可以在不必担心骨折风险的情况下进行,即使在患有骨质疏松症的患者中也是如此.
- 关于CSI的临床决定不应该被潜在的骨折风险所阻止.
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