Journal ArticleDOI
Prevalence of oral glucocorticoid usage in the United States: a general population perspective.
Reads0
Chats0
TLDR
This study aimed to estimate the prevalence of glucocorticoid use, duration of use, and concomitant use of antiosteoporosis pharmaceuticals in the US population age ≥20 years.Abstract:
Objective
There is little information on oral glucocorticoid use in the general US population. Previously, there have been published estimates of glucocorticoid use in countries outside of the US. This study aimed to estimate the prevalence of glucocorticoid use, duration of use, and concomitant use of antiosteoporosis pharmaceuticals in the US population age ≥20 years.
Methods
Data from 5 cycles (1999–2008) of the National Health and Nutrition Examination Survey (NHANES) were used to provide nationally representative weighted estimates. Oral glucocorticoids and concomitant use of antiosteoporosis pharmaceuticals (bisphosphonates, calcitonin, calcium, hormone replacement therapies, teriparatide, and vitamin D) were analyzed.
Results
There were 356 NHANES respondents ages ≥20 years who reported use of an oral glucocorticoid in the combined cycles between 1999 and 2008. The weighted prevalence of oral glucocorticoid use was 1.2% (95% confidence interval [95% CI] 1.1–1.4) from 1999–2008, corresponding to 2,513,259 persons in the US. The mean duration of oral glucocorticoid use was 1,605.7 days (95% CI 1,261.2–1,950.1), and 28.8% (95% CI 22.2–35.4) of oral glucocorticoid users reported use for ≥5 years. Concomitant use of a bisphosphonate was reported by 8.6% (95% CI 5.1–11.7) of oral glucocorticoid users, and 37.9% (95% CI 31.7–44.0) reported usage of any antiosteoporosis pharmaceutical.
Conclusion
Based on NHANES data from 1999–2008, it is estimated that the prevalence of glucocorticoid use in the US is 1.2%, with a long duration of use and infrequent use of antiosteoporotic medications compared to other estimates.read more
Citations
More filters
Journal ArticleDOI
Short term use of oral corticosteroids and related harms among adults in the United States: population based cohort study
Akbar K. Waljee,Mary A.M. Rogers,Paul Lin,Amit G. Singal,Joshua D. Stein,Rory M. Marks,John Z. Ayanian,Brahmajee K. Nallamothu +7 more
TL;DR: One in five American adults in a commercially insured plan were given prescriptions for short term use of oral corticosteroids during a three year period, with an associated increased risk of adverse events.
Journal ArticleDOI
Glucocorticoid-induced osteoporosis.
Karine Briot,Christian Roux +1 more
TL;DR: In patients with rheumatoid arthritis, a treat-to-target strategy focusing on low disease activity including through the use of low dose of prednisone, is a key determinant of bone loss prevention.
Journal ArticleDOI
The human stress response.
TL;DR: The role of the hypothalamic–pituitary–adrenal axis in synchronizing the stress response with circadian regulatory processes and maintaining homeostasis is outlined.
Journal ArticleDOI
Glucocorticoid-induced osteoporosis: an update.
TL;DR: Teriparatide has been shown to be superior in its effects on BMD and vertebral fracture risk in glucocorticoid-treated individuals with osteoporosis and should be considered as an alternative first line option in high-risk patients.
Journal ArticleDOI
11β-HSD1 is the major regulator of the tissue-specific effects of circulating glucocorticoid excess.
Stuart A. Morgan,Emma McCabe,Laura Gathercole,Zaki Hassan-Smith,Dean Larner,Iwona J. Bujalska,Paul M. Stewart,Jeremy W. Tomlinson,Gareth G. Lavery +8 more
TL;DR: In this paper, 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) was found to be critical to developing the phenotype of Cushing syndrome.
References
More filters
Journal ArticleDOI
The epidemiology of corticosteroid-induced osteoporosis: a meta-analysis.
TL;DR: It is concluded that oral corticosteroid treatment using more than 5 mg (of prednisolone or equivalent) daily leads to a reduction in bone mineral density and a rapid increase in the risk of fracture during the treatment period.
Journal ArticleDOI
Recommendations for the Prevention and Treatment of Glucocorticoid-Induced Osteoporosis
Marc C. Hochberg,Mark J. Prashker,Maria Greenwald,Rancho Mirage,Marian T. Hannan,Nancy E Lane,Stephen M. Lindsey,Daniel J. Lovell,Elizabeth A. Tindall +8 more
TL;DR: Treatment with a bisphosphonate is recommended to prevent bone loss in all men and postmenopausal women in whom long-term glucocorticoid treatment at > or =5 mg/day is being initiated, as well as in men andPost menopausal women receiving long- term glucocORTicoids in whom the BMD T-score at either the lumbar spine or the hip is below normal.
Journal ArticleDOI
Estimating hip fracture morbidity, mortality and costs.
TL;DR: To estimate lifetime morbidity, mortality, and costs from hip fracture incorporating the effect of deficits in activities of daily living, a large number of patients with hip fracture have had at least one hip replacement.
Journal ArticleDOI
A meta-analysis of prior corticosteroid use and fracture risk.
John A. Kanis,Helena Johansson,Anders Odén,Olof Johnell,Chris De Laet,L. Joseph Melton,Alan Tenenhouse,Jonathan Reeve,Alan J. Silman,Huibert A. P. Pols,John A. Eisman,Eugene V. McCloskey,Dan Mellström +12 more
TL;DR: The relationship between use of corticosteroids and fracture risk was estimated in a meta‐analysis of data from seven cohort studies of ∼42,000 men and women.
Journal ArticleDOI
American College of Rheumatology 2010 recommendations for the prevention and treatment of glucocorticoid-induced osteoporosis.
Jennifer M. Grossman,Rebecca Gordon,Veena K. Ranganath,Chad L. Deal,Liron Caplan,Weiling Chen,Jeffrey R. Curtis,Daniel E. Furst,Maureen McMahon,Nivedita M. Patkar,Elizabeth R. Volkmann,Kenneth G. Saag +11 more
TL;DR: Guidelines and recommendations developed and/or endorsed by the American College of Rheumatology are intended to provide guidance for particular patterns of practice and not to dictate the care of a particular patient.