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Steroid use increases risk of fracture

01 April 2001

New British data suggest that patients taking daily corticosteroids are at a significantly increased risk of fractured bones.

For this study, the researchers categorised the subjects according to their daily dose of steroids, which resulted in three groups: low dose (less than 2.5 mg daily), medium dose (2.5- 7.5 mg daily) and high dose (more than 7.5 mg daily). They were compared with a group of individuals who were not taking steroids.

According to their findings, the risk of fracture increased at a much lower dose than presumed above 2.5 mg not 7.5 mg daily as previously thought.

Compared with the low dose group, patients receiving a high dose had 1.44 times the risk of non vertebral fractures, 2.83 times the risk of vertebral fractures and 2.21 times the risk for hip fractures. In comparison to controls, patients taking more than 5 mg/day of steroids had a 20 per cent increased risk of fractures. Those taking more than 20 mg daily had a 60 per cent increased risk. The researchers further noted that the effect of steroids on bones was rapid and possibly cumulative.

The only good news in this study was that the risk of fracture apparently reverted to normal once the steroid was discontinued (Rheumatology, 2000; 39: 1383-9).

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