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POS1432 (2021)
SHORT-TERM RISK OF OSTEOPOROSIS IN ADULTS TREATED WITH CORTICOSTEROIDS: AN OBSERVATIONAL STUDY
E. Berni1, P. Ambery2, S. Adamsson Eryd3, S. Jenkins-Jones1, M. Brown4, C. Astbury5, P. Hunt6, C. Currie1,7
1Pharmatelligence, Epidemiology, Cardiff, United Kingdom
2AstraZeneca, Late-Stage Development, Cardiovascular, Renal and Metabolism, BioPharmaceuticals R&D, Gothenburg, Sweden
3AstraZeneca, BioPharmaceuticals Medical, CVRM Evidence, Gothenburg, Sweden
4AstraZeneca, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, Boston, United States of America
5AstraZeneca, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, Cambridge, United Kingdom
6AstraZeneca, BioPharmaceuticals Medical, CVRM Evidence, Gaithersburg, United States of America
7Cardiff University, School of Medicine, Cardiff, United Kingdom

Background: Exposure to corticosteroids is recognised to increase the risk of osteoporosis.


Objectives: Our aim was to evaluate patients’ short-term absolute risk of osteoporosis over the course of their first continuous exposure to corticosteroids.


Methods: This was an observational study using UK data from the Clinical Practice Research Datalink. Adult patients were selected if exposed to systemic corticosteroids for any condition and had no prior osteoporosis. Non-exposed adults matched on age, sex, and disease burden were selected from the general population. Patients were followed from their first exposure to corticosteroid to the earlier of 90 days following the end of continuous prescribing or for a maximum of three years. Cohorts were categorised by age (18-42 years, 43-67 and 68-92 years), BMI (underweight, normal overweight, obese and obese+) and gender. Absolute risk rates were calculated for each of these categories.


Results: In total, 573,056 exposed patients were matched 1:1 to non-exposed controls. Mean age was 52 years; 57% were female. The mean and median days’ supply were 50.9 and 13 days, respectively. Underweight females aged 68-92 years exposed to corticosteroids had the highest absolute risk of osteoporosis (70.9 per 1000 patient years (PKPY)); in matched non-exposed controls this was 26.6 PKPY. Generally, following their first continuous exposure to corticosteroids, patients taking steroids had greater risk of osteoporosis compared with those in the same age, sex and BMI category never exposed to corticosteroids.


Conclusion: Whilst it is understood that exposure to corticosteroids increases the risk of osteoporosis, there are large differences in risk in accordance with age, sex and BMI. Alternatives to corticosteroids are urgently needed.

Male Female
Steroid-exposed Never exposed Steroid-exposed Never exposed
Age group BMI group Patients Absolute rate (per 1,000 patient years) Patients Absolute rate (per 1,000 patient years) p -value Patients Absolute rate (per 1,000 patient years) Patients Absolute rate (per 1,000 patient years) p -value
18-42 1: Underweight 1,242 2.0 1,195 0.0 0.5661 3,079 4.5 3,486 0.9 0.1361
2: Normal 18,798 2.2 19,638 0.0 <0.0001 42,234 0.9 47,340 0.1 0.0049
3: Overweight 16,536 2.6 15,114 0.0 0.0001 24,893 0.5 24,009 0.1 0.2382
4: Obese + 10,311 0.6 8,453 0.0 0.2874 26,600 0.6 20,320 0.3 0.4614
43-67 1: Underweight 1,254 27.4 683 0.0 0.0040 2,420 30.9 1,990 18.5 0.1141
2: Normal 27,037 8.6 26,569 2.0 <0.0001 45,467 15.9 50,423 6.1 <0.0001
3: Overweight 42,428 4.3 43,872 0.7 <0.0001 42,620 10.8 43,253 4.1 <0.0001
4: Obese + 31,478 2.5 30,852 0.8 0.0007 45,339 6.0 39,876 2.4 <0.0001
68-92 1: Underweight 936 30.3 432 10.3 0.1505 1,532 70.9 1,239 26.6 0.0003
2: Normal 15,891 11.3 15,021 4.5 <0.0001 18,308 42.3 18,717 18.6 <0.0001
3: Overweight 21,371 7.3 23,137 1.8 <0.0001 19,149 26.2 19,760 12.9 <0.0001
4: Obese + 11,216 5.6 11,396 1.9 0.0021 14,453 20.0 13,614 8.7 <0.0001

Disclosure of Interests: Ellen Berni Consultant of: Employed by Pharmatelligence, which carries out consultancy work for AstraZeneca and other pharmaceutical companies., Philip Ambery Shareholder of: AstraZeneca, Employee of: AstraZeneca, Samuel Adamsson Eryd Shareholder of: AstraZeneca, Employee of: AstraZeneca, Sara Jenkins-Jones Consultant of: Employed by Pharmatelligence, which carries out consultancy work for AstraZeneca and other pharmaceutical companies., Mary Brown Shareholder of: AstraZeneca, Employee of: AstraZeneca, Carol Astbury Shareholder of: AstraZeneca, Employee of: AstraZeneca, Phillip Hunt Shareholder of: AstraZeneca, Employee of: AstraZeneca, Craig Currie Consultant of: Director of Pharmatelligence, which carries out consultancy work for AstraZeneca and other pharmaceutical companies

Citation: Ann Rheum Dis, volume 80, supplement 1, year 2021, page 1000
Session: Epidemiology, risk factors for disease or disease progression (POSTERS only)