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Osteoporosis Risk Increased With Long-Term Topical Corticosteroid Exposure

Dose-response relationships identified between long-term exposure to TCSs and osteoporosis and major osteoporotic fracture

By Elana Gotkine (HealthDay News) | December 20, 2023

WEDNESDAY, Dec. 20, 2023 (HealthDay News) -- The risk for osteoporosis and major osteoporotic fracture (MOF) is increased in association with long-term exposure to topical corticosteroids (TCSs), according to a study published online Dec. 20 in the Journal of the European Academy of Dermatology and Venereology.

Bing-Jun Hsieh, from the National Taiwan University Hospital in Taipei, and colleagues examined the association of cumulative doses of TCSs of varying potency with osteoporosis and MOF using data from the Taiwan National Health Insurance Research Database. Cumulative TCS doses were calculated in different exposure periods; the potency was converted to prednisolone equivalent.

A total of 129,682 osteoporosis cases and 34,999 MOF cases were selected from 2017 to 2020 and randomly matched to 518,728 and 139,996 controls by sex and age, respectively. The researchers identified clear dose-response relationships between long-term exposure to TCSs and osteoporosis and MOF. For osteoporosis, the adjusted odds ratios were 1.216, 1.260, and 1.341 for exposure to low, medium, and high cumulative TCS doses, respectively, compared with no TCSs, over five years. For MOF, the corresponding adjusted odds ratios were 1.118, 1.191, and 1.288. In a stratified analysis, higher odds ratios for osteoporosis and MOF were seen for women than men. Compared with other age groups, younger people (younger than 50 years) had the highest odds ratio for osteoporosis.

"High cumulative doses of TCSs should be used with caution, especially in susceptible populations," the authors write.

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