A recent cohort study investigated the association between cumulative corticosteroid injections and fracture risk. The study encompassed 7,197 patients from Minnesota, treated at the Mayo Clinic over a four-year period. The results indicated no significant association between cumulative corticosteroid injections and increased fracture risk, even among those with preexisting osteoporosis.
Published in JAMA Network Open, the study included participants with a mean age of 64.4 years, 61.6% of whom were women. During the study period, 346 patients (4.8%) experienced new fractures, with 43.1% of these classified as osteoporotic. The analysis revealed no significant association between the cumulative dose of corticosteroid injections (CSIs) and fracture risk. The adjusted hazard ratio for fracture risk based on cumulative CSI dose was 1.04 (95% CI, 0.96-1.11).
Subgroup analyses provided additional insights. Among patients without a high baseline fracture risk and those with preexisting osteoporosis, cumulative CSI dose did not significantly affect fracture incidence. Notable risk factors for fractures included age, Charlson Comorbidity Index, and a history of previous fractures.
The authors concluded, “Clinicians should be reassured that frequent CSI is not associated with higher fracture risk and should not withhold these pain treatments owing to concern for fracture.”
The authors reported no conflicts of interest.