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Topical corticosteroids affect incidence of osteoporosis, major osteoporotic fractures

Photo by Enareksi via Wikimedia Commons

In a large retrospective case–control study published in the Journal of the European Academy of Dermatology and Venereology, Taiwanese researchers found an association between the cumulative dose of topical corticosteroids (TCSs) and the heightened risk of osteoporosis and major osteoporotic fractures (MOF) in the Taiwanese population.

Analyzing data from the Taiwan National Health Insurance Research Database spanning 2017 to 2020, the study selected 129,682 osteoporosis cases and 34,999 MOF cases, randomly matching them with 518,728 and 139,996 controls, respectively, based on sex and age. The findings illuminated clear dose–response relationships that showed as the cumulative TCS dose increased, so did the risk of osteoporosis and MOF.

For instance, compared to those with no TCS use, individuals exposed to low, medium, and high cumulative TCS doses over five years exhibited adjusted odds ratios (ORs) of 1.216, 1.260, and 1.341 for osteoporosis, and 1.118, 1.191, and 1.288 for MOF, respectively. Stratified analysis revealed that women faced higher ORs for both osteoporosis and MOF compared to men, emphasizing a gender-specific vulnerability. Furthermore, younger individuals (<50 years) demonstrated the highest ORs for osteoporosis, underscoring the age-related impact.

“This study emphasizes that using topical corticosteroids to treat inflammatory skin conditions should be done very carefully and clinicians should be aware of these potential side effects,” said corresponding author Chia-Yu Chu, MD PhD, of National Taiwan University Hospital and National Taiwan University College of Medicine in a press release.

There is a need for caution in the long-term use of TCSs, particularly in susceptible populations such as women and young individuals, the authors wrote.


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