Public health impact of adverse bone effects of oral corticosteroids

Aims The objective of this study was to estimate the number of Fractures at tributed to oral corticosteroid use. Methods Information was obtained from the General Practice Research Databas e which contains medical records of general practitioners in the UK. The to tal number of corticorteroid-related fractures during a course of treatment was estimated using the formula for attributable risk among the exposed. Results A total of 244 235 patients was prescribed an oral corticosteroid. The rate of hip fractures increased exponentially with age in both males an d females. The excess number of hip fracture cases among females aged 85 ye ars or older using 7.5 mg prednisolone per day or more was 1.4 cases per 10 0 patients per year. About 47% of all hip and 72% of all vertebral fracture s that occurred can be attributed to oral corticosteroid use. Among 10 000 female users of higher doses, 99.7 nonvertebral, 31.6 hip and 45.8 vertebra l fractures can be attributed to use of oral corticosteroids. Conclusions The targeting of high-risk patients will be important for imple menting preventative strategies in a cost-effective manner.