title: Incidence of nonvertebral fractures in relation to time on treatment and bone density in glucocorticoid-treated patients: a retrospective approach.
abstract: The effects of duration of treatment and bone mineral density (BMD) on nonvertebral fracture in 560 glucocorticoid users were examined by using baseline and retrospective data from 2 parallel studies assessing the efficacy and safety of alendronate therapy. Baseline spine and hip BMD were significantly (P < 0.01) lower with increased time spent receiving glucocorticoids. Forty-three patients (7.7%) had experienced at least 1 nonvertebral fracture after starting glucocorticoid treatment. The hazard function for nonvertebral fracture occurrence increased significantly (P < 0.01) with time spent receiving glucocorticoids: fracture incidence per 1,000 person-years on glucocorticoids was 18 (< 5 years), 31 (5-10 years), and 35 (> 10 years). Patients with a history of nonvertebral fractures after starting glucocorticoid treatment had significantly lower lumbar spine (P < 0.01) and hip (< 0.01) BMD value than those without fractures. This retrospective analysis suggests that a BMD measurement of spine and hip may identify risk for nonvertebral fractures in a heterogeneous population of glucocorticoid users.
authors.affiliation: Ghent University Hospital, Ghent, Belgium. stefan.goemaere@rug.ac.be
authors.forename: S
authors.initials: S
authors.lastname: Goemaere
authors.forename: U A
authors.initials: UA
authors.lastname: Liberman
authors.forename: J D
authors.initials: JD
authors.lastname: Adachi
authors.forename: F
authors.initials: F
authors.lastname: Hawkins
authors.forename: N
authors.initials: N
authors.lastname: Lane
authors.forename: K G
authors.initials: KG
authors.lastname: Saag
authors.forename: T
authors.initials: T
authors.lastname: Schnitzer
authors.forename: J M
authors.initials: JM
authors.lastname: Kaufman
authors.forename: M P
authors.initials: MP
authors.lastname: Malice
authors.forename: W
authors.initials: W
authors.lastname: Carofano
authors.forename: A
authors.initials: A
authors.lastname: Daifotis