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Risk Factors of Van Staa et al for Vertebral Fracture Associated with Oral Glucocorticoid Therapy

Description

Van Staa et al identified risk factors for vertebral fractures in a patient being treated with oral glucocorticoid therapy. This can help identify a patient who may require closer monitoring or a change in therapy to reduce the risk. The authors are from the University of Southampton, Utrecht University, University Center Nijmegen, St. Paul Medical Center (Dallas), University of Aberdeen, and Proctor & Gamble Pharmaceuticals.


 

Facts:

(1) A patient on daily oral glucocorticosteroid therapy has an increased risk for fracture.

(2) A person on oral steroids does not need to have osteoporosis to develop a fracture but osteoporosis increases the risk.

(3) The risk increases rapidly after starting the oral glucocorticosteroid therapy (page 3228).

 

Risk factors for vertebral fracture:

(1) decrease in lumbar spine bone mass density, with a negative T score (relative risk = (1.86 * ABS(T score)))

(2) daily oral glucocorticosteroid therapy (relative risk = (daily oral dose in mg) / 10 * 1.62) in prednisone or equivalent)

(3) postmenopausal female

(4) failure to receive or take prophylactic therapy to reverse osteoporosis (bisphosphonate, calcium, vitamin D, etc.) when indicated (I used a T score <= -1.0 in the implementation).

 


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Specialty

ICD-10