{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T09:40:23Z","timestamp":1775122823426,"version":"3.50.1"},"reference-count":28,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,1,30]],"date-time":"2020-01-30T00:00:00Z","timestamp":1580342400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100012276","name":"Tillotts Pharma","doi-asserted-by":"crossref","award":["AGR-2017-731-2678"],"award-info":[{"award-number":["AGR-2017-731-2678"]}],"id":[{"id":"10.13039\/501100012276","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Due to a substantial first\u2010pass metabolism of oral budesonide, systemic bioavailability is low compared to other oral corticosteroids, thereby possibly avoiding adverse effects of systemic corticosteroid use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To determine whether use of oral budesonide is associated with osteoporotic fractures in patients with microscopic colitis (MC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Applying data from the Danish nationwide health registries, we conducted a case\u2010control study nested within a cohort of patients with MC from 2004 to 2012. We estimated odds ratios (ORs) for the association between budesonide use and osteoporotic fractures (hip, wrist and spinal fractures).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 417 cases with a first occurrence of an osteoporotic fracture. Eighty\u2010six per cent were women and the median age was 78\u00a0years. The OR for the overall association between ever\u2010use of budesonide and any osteoporotic fractures did not reach statistical significance (OR 1.13, CI: 0.88\u20101.47). The highest risk was observed for spinal fractures (OR 1.98, CI: 0.94\u20104.17), where a dose\u2010response association seemed to exist, followed by hip and wrist fractures (OR 1.17 [CI: 0.79\u20101.73] and OR 0.99 [CI: 0.66\u20101.47] respectively). We generally found modestly increased ORs across subgroups at suspected high or low risk of fractures (1.00\u20102.49). No overall dose\u2010response association was evident (OR for doubling of cumulative dose 0.93 (CI: 0.84\u20101.03).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>No overall association between use of oral budesonide and osteoporotic fractures was demonstrated among individuals with MC. There seemed to be an isolated adverse effect of budesonide on the risk of spinal fractures, which appears to be dose related.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.15648","type":"journal-article","created":{"date-parts":[[2020,1,31]],"date-time":"2020-01-31T02:09:25Z","timestamp":1580436565000},"page":"644-651","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Long\u2010term oral budesonide treatment and risk of osteoporotic fractures in patients with microscopic colitis"],"prefix":"10.1111","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1241-4385","authenticated-orcid":false,"given":"Mette","family":"Reilev","sequence":"first","affiliation":[{"name":"Clinical Pharmacology and Pharmacy Department of Public Health University of Southern Denmark Odense University Hospital Odense Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jesper","family":"Hallas","sequence":"additional","affiliation":[{"name":"Clinical Pharmacology and Pharmacy Department of Public Health University of Southern Denmark Odense University Hospital Odense Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Thomsen Ernst","sequence":"additional","affiliation":[{"name":"Clinical Pharmacology and Pharmacy Department of Public Health University of Southern Denmark Odense University Hospital Odense Denmark"},{"name":"OPEN \u2013 Open Patient data Explorative Network Department of Clinical Research University of Southern Denmark Odense Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gunnar Lauge","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Aalborg University Hospital Aalborg Denmark"},{"name":"Department of Clinical Medicine Aalborg University Aalborg 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