Corticosteroid injections may not be associated with subsequent osteoporotic fracture
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Key takeaways:
- Researchers found no association between cumulative doses of injected corticosteroids and increased fracture risk.
- Corticosteroids were not associated with increased fracture risk in patients with osteoporosis.
According to published results, cumulative doses of injected corticosteroids were not associated with increased risk of any subsequent fracture or subsequent osteoporotic fracture.
Researchers from the Mayo Clinic performed a cohort study of 7,197 patients (mean age, 64.4 years) who received any corticosteroid injections from May 1, 2018, to July 1, 2022. Researchers assessed patients’ fracture risk per triamcinolone equivalents received. They also assessed fracture risk among subgroups of patients who were not at high risk for fractures and patients with osteoporosis.
Overall, 346 patients (4.8%) had a new fracture during the 4-year study period, with 149 fractures (43.1%) considered osteoporotic. Researchers noted mean time from first corticosteroid injection to fracture was 329 days and mean total cumulative corticosteroid injection dose was 141.8 mg in triamcinolone equivalents.
Researchers found no association between increased fracture risk and cumulative corticosteroid injection dose (adjusted HR = 1.04). They also found no association between increased fracture risk among the subgroups of patients who were not at high risk for fractures (aHR = 1.11) and patients with osteoporosis (aHR = 1.01). They noted age (aHR = 1.45), Charleson Comorbidity Index (aHR = 1.07) and previous fracture (aHR = 3.26) were the only factors associated with increased fracture risk.
“Clinicians should be reassured that frequent [corticosteroid injection] CSI is not associated with higher fracture risk and should not withhold these important pain treatments owing to concern for fracture,” the researchers wrote in the study.
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