Veterans Affairs Boston Healthcare System, Surgical Service, Boston, Massachusetts, USA.
Massachusetts Eye and Ear, Harvard Medical School, Department of Ophthalmology, Boston, Massachusetts, USA.
Ocul Immunol Inflamm. 2024 Aug;32(6):994-1002. doi: 10.1080/09273948.2023.2182793. Epub 2023 Mar 9.
Currently, little is known regarding bone health surveillance for glucocorticoid-exposed non-infectious uveitis (NIU) patients or their baseline risks of skeletal fragility outcomes.
Using claims data, we calculated rates of dual-energy x-ray absorptiometry (DXA) screening for glucocorticoid-exposed NIU and rheumatoid arthritis (RA) patients. Separately, we compared risks of skeletal fragility metrics amongst NIU patients, RA patients, and controls, independent of glucocorticoid use.
The adjusted hazard ratio (aHR) of NIU patients to have a DXA scan was 0.64 (95% CI, 0.63-0.65; < .001) compared to RA patients. The aHR for any skeletal fragility outcome amongst NIU patients was 0.97 ( < .02) compared to normal controls, while RA patients had excess risk (aHR, 1.15; < .001).
NIU patients are 36% less likely to receive a DXA scan after high-dose glucocorticoid exposure compared with RA patients. No elevated risk of osteoporosis for NIU patients was found compared to normal controls.
目前，对于接受糖皮质激素治疗的非感染性葡萄膜炎（NIU）患者或其骨骼脆弱性结局的基线风险，人们知之甚少。
我们使用索赔数据计算了接受糖皮质激素治疗的 NIU 和类风湿关节炎（RA）患者进行双能 X 线吸收法（DXA）筛查的比率。另外，我们比较了 NIU 患者、RA 患者和对照组在不考虑糖皮质激素使用的情况下骨骼脆弱性指标的风险。
与 RA 患者相比，NIU 患者接受 DXA 扫描的调整后危险比（aHR）为 0.64（95%CI，0.63-0.65；<0.001）。与正常对照组相比，NIU 患者任何骨骼脆弱性结局的 aHR 为 0.97（<0.02），而 RA 患者则存在过度风险（aHR，1.15；<0.001）。
与 RA 患者相比，接受高剂量糖皮质激素治疗的 NIU 患者接受 DXA 扫描的可能性低 36%。与正常对照组相比，NIU 患者并未发现骨质疏松症风险增加。
