Cited by 559Bone health and osteoporosis researchMenopause: Health Impacts and TreatmentsBone health and treatments

Bone density threshold and other predictors of vertebral fracture in patients receiving oral glucocorticoid therapy

Van Staa, T. P., Laan, R. F., Barton, I. P., Cohen, S., Reid, D. M., Cooper, C.·2003·Arthritis & Rheumatism

Abstract

OBJECTIVE: To evaluate predictors of vertebral fractures, including a threshold for bone mineral density (BMD), in patients receiving oral glucocorticoids (GCs). METHODS: Data were obtained from 2 randomized clinical trials (prevention and treatment trials of risedronate) using similar methods, but different inclusion criteria were applied with regard to prior exposure to GCs. Predictors of vertebral fracture in the placebo group were identified using Cox regression with forward selection. The BMD threshold analysis involved a comparison of the 1-year fracture risk in postmenopausal women receiving placebo in the GC trials with that in postmenopausal women not taking GCs in 3 other trials. RESULTS: The study population comprised 306 patients with baseline and 1-year followup data on vertebral fractures (111 receiving placebo and 195 receiving risedronate). In the placebo group, the statistically significant predictors of incident fracture were the baseline lumbar spine BMD (for each 1-point decrease in T score, relative risk [RR] 1.85, 95% confidence interval [95% CI] 1.06-3.21) and the daily GC dose (for each 10-mg dose increase, RR 1.62, 95% CI 1.11-2.36). In the BMD threshold analysis, compared with nonusers of GCs, patients receiving GCs were younger, had a higher BMD at baseline, and had fewer prevalent fractures; nevertheless, the risk of fracture was higher in the GC users compared with nonusers (adjusted RR 5.67, 95% CI 2.57-12.54). The increased risk of fracture was observed in GC users regardless of whether osteoporosis was present. CONCLUSION: The daily, but not cumulative, GC dose was found to be a strong predictor of vertebral fracture in patients receiving GCs. At similar levels of BMD, postmenopausal women taking GCs, as compared with nonusers of GCs, had considerably higher risks of fracture.

Integrity signals

Registry

Crossref · 10.1002/art.11283

Cites

29 of 29 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Authors
Van Staa, T. P., Laan, R. F., Barton, I. P., Cohen, S., Reid, D. M., & Cooper, C.
Affiliations
  • Procter & Gamble (United Kingdom) (GB)
  • University of Aberdeen (GB)
  • University of Southampton (GB)
Venue
Arthritis & Rheumatism
Publisher
Wiley
Published
2003-11
Volume
48
Issue
11
Pages
3224-3229
ISSN
  • 0004-3591 (ISSN-L)
  • 1529-0131
OpenAlex
W1978136096
Cited by
559
References
29
Citations by year
2026: 6 · 2025: 14 · 2024: 11 · 2023: 13 · 2022: 21 · 2021: 27 · 2020: 28 · 2019: 30 · 2018: 36 · 2017: 30 · 2016: 28 · 2015: 36 · 2014: 29 · 2013: 29 · 2012: 23
FWCI
21.19
Type
journal article
Language
en
Open access
closed
Locations
  • Arthritis & Rheumatism (publishedVersion)
  • PubMed (publishedVersion)
  • Research Explorer (The University of Manchester) (publishedVersion)
  • ePrints Soton (University of Southampton) (submittedVersion)
  • Radboud Repository (Radboud University) (submittedVersion)
Topics
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
  • Health Sciences › Medicine › Oncology › Bone health and treatments
Keywords
vertebral fractures, oral corticosteroids, bone mineral density, fracture risk prediction, risedronate, postmenopausal women, glucocorticoid dose, osteoporosis, lumbar spine bone mineral density, T-score thresholds
MeSH terms
Administration, Oral, Adolescent, Adult, Aged, Aged, 80 and over, Double-Blind Method, Female, Femur Neck, Glucocorticoids, Humans, Lumbar Vertebrae, Male, Middle Aged, Prednisone, Risk, Risk Factors, Absorptiometry, Photon, Bone Density, Osteoporosis, Postmenopausal, Spinal Fractures, Postmenopause

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review