Topical steroids may increase risk of osteoporosis, fractures: JAMA Study

It was a Danish population-based, retrospective cohort study that included 723 251 Danish adults treated with the equivalent of at least 200 g of mometasone from January 1, 2003, to December 31, 2017. Researchers used Danish nationwide registries to obtain data. Filled prescription data were converted in equipotent doses to mometasone furoate (1 mg/g). The major outcomes assessed were a diagnosis of osteoporosis or MOF.

Key findings of the study were:

♦ Researchers found a dose-response association between the increased use of potent or very potent TCSs and the risk of osteoporosis and MOF. (Eg., HRs of MOF were:  

                    • 1.01 for exposure to 500 to 999 g,

                    • 1.05 for exposure to 1000 to 1999 g,

                    • 1.10 for exposure to 2000 to 9999 g,

                    • 1.27 for exposure to at least 10 000 g).

♦ They found an overall population-attributable risk for TCSs of as much as 4.3% for osteoporosis and 2.7% for MOF.

♦ Upon doubling the cumulative TCS dose, they observed a 3% increase in the relative risk of osteoporosis and MOF (HR, 1.03 ).

The authors concluded, "These findings demonstrate that use of high cumulative amounts of potent or very potent TCSs was associated with an increased risk of osteoporosis and MOF".

For further information:

https://jamanetwork.com/journals/jamadermatology/fullarticle/2775153