論文

査読有り 国際誌
2017年6月

Very high frequency of fragility fractures associated with high-dose glucocorticoids in postmenopausal women: A retrospective study.

Bone reports
  • Goichi Kageyama
  • ,
  • Takaichi Okano
  • ,
  • Yuzuru Yamamoto
  • ,
  • Keisuke Nishimura
  • ,
  • Daisuke Sugiyama
  • ,
  • Jun Saegusa
  • ,
  • Goh Tsuji
  • ,
  • Shunichi Kumagai
  • ,
  • Akio Morinobu

6
開始ページ
3
終了ページ
8
記述言語
英語
掲載種別
DOI
10.1016/j.bonr.2016.11.003

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.

リンク情報
DOI
https://doi.org/10.1016/j.bonr.2016.11.003
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/28377975
PubMed Central
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5365272

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