{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T05:06:31Z","timestamp":1789016791750,"version":"build-2803163510"},"reference-count":21,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2006,12,28]],"date-time":"2006-12-28T00:00:00Z","timestamp":1167264000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthritis &amp; Rheumatism"],"published-print":{"date-parts":[[2007,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the risk of fracture in patients receiving intermittent therapy with high\u2010dose oral glucocorticoids (GCs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The study group comprised 191,752 patients from the UK General Practice Database who were 40 years of age and older and received therapy with GCs. The followup time period was divided into the categories of \u201ccurrent\u201d and \u201cno exposure.\u201d The daily dose and cumulative dose for each time period were determined. Relative risks were estimated using Cox proportional hazards models, adjusted for age, sex, body mass index, smoking, disease history, and drug history. Fractures of the radius\/ulna, humerus, rib, femur\/hip, pelvis, or vertebrae were included in the evaluation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Patients who intermittently received high\u2010dose GCs (daily dose \u226515 mg) and had no or little previous exposure to GCs (cumulative exposure \u22641 gm) had a small increased risk of osteoporotic (but not hip\/femur) fracture; this risk increased substantially with increasing cumulative exposure. Among patients who received a daily dose \u226530 mg and whose cumulative exposure was &gt;5 gm, the relative risk (RR) of osteoporotic fracture was 3.63 (95% confidence interval [95% CI] 2.54\u20135.20), the RR of fracture of the hip\/femur was 3.13 (95% CI 1.49\u20136.59), and the RR of vertebral fracture was 14.42 (95% CI 8.29\u201325.08).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Intermittent use of high\u2010dose oral GCs (daily dose \u226515 mg and cumulative exposure \u22641 gm) may result in a small increased risk of osteoporotic fracture. Conversely, patients who receive several courses of high\u2010dose GCs (daily dose \u226515 mg and cumulative exposure &gt;1 gm) have a substantially increased risk of fracture.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/art.22294","type":"journal-article","created":{"date-parts":[[2006,12,28]],"date-time":"2006-12-28T19:47:42Z","timestamp":1167335262000},"page":"208-214","source":"Crossref","is-referenced-by-count":248,"title":["Fracture risk with intermittent high\u2010dose oral glucocorticoid therapy"],"prefix":"10.1002","volume":"56","author":[{"given":"Frank","family":"De Vries","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madelon","family":"Bracke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hubert G. M.","family":"Leufkens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan\u2010Willem J.","family":"Lammers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cyrus","family":"Cooper","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tjeerd P.","family":"Van Staa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2007,1,2]]},"reference":[{"key":"e_1_2_7_2_2","doi-asserted-by":"publisher","DOI":"10.1359\/JBMR.040134"},{"key":"e_1_2_7_3_2","doi-asserted-by":"publisher","DOI":"10.1359\/jbmr.2000.15.6.993"},{"key":"e_1_2_7_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/39.12.1383"},{"key":"e_1_2_7_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.11283"},{"key":"e_1_2_7_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2004.02207.x"},{"key":"e_1_2_7_7_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.121.5.1456"},{"key":"e_1_2_7_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1996.00550080071014"},{"key":"e_1_2_7_9_2","first-page":"1083","article-title":"Effects of high dose methylprednisone pulse therapy on bone mass and biochemical markers of bone metabolism in patients with active rheumatoid arthritis: a 12\u2010month randomized prospective controlled study","volume":"31","author":"Frediani B","year":"2004","journal-title":"J Rheumatol"},{"key":"e_1_2_7_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(97)04248-7"},{"key":"e_1_2_7_11_2","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/hci029"},{"key":"e_1_2_7_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/00001648-199507000-00005"},{"key":"e_1_2_7_13_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.120.5.1468"},{"key":"e_1_2_7_14_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199503233321202"},{"key":"e_1_2_7_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0889-8529(05)70017-7"},{"key":"e_1_2_7_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.micron.2005.07.009"},{"key":"e_1_2_7_17_2","doi-asserted-by":"publisher","DOI":"10.1210\/en.2003-0990"},{"key":"e_1_2_7_18_2","doi-asserted-by":"publisher","DOI":"10.1172\/JCI2799"},{"key":"e_1_2_7_19_2","doi-asserted-by":"publisher","DOI":"10.1359\/jbmr.2000.15.6.1001"},{"key":"e_1_2_7_20_2","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2003.008839"},{"key":"e_1_2_7_21_2","doi-asserted-by":"publisher","DOI":"10.1359\/jbmr.2000.15.1.13"},{"key":"e_1_2_7_22_2","doi-asserted-by":"publisher","DOI":"10.1359\/jbmr.2001.16.1.97"}],"container-title":["Arthritis &amp; Rheumatism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fart.22294","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/art.22294","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,11]],"date-time":"2023-10-11T17:22:46Z","timestamp":1697044966000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/art.22294"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2007,1]]},"references-count":21,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2007,1]]}},"alternative-id":["10.1002\/art.22294"],"URL":"https:\/\/doi.org\/10.1002\/art.22294","archive":["Portico"],"relation":{},"ISSN":["0004-3591","1529-0131"],"issn-type":[{"value":"0004-3591","type":"print"},{"value":"1529-0131","type":"electronic"}],"subject":[],"published":{"date-parts":[[2007,1]]}}}