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AB0857 Problems of diagnostics and prophylaxis of glucocorticoid-induced osteoporosis in real clinical practice
  1. S Yakupova,
  2. R Demidov
  1. Kazan State Medical University, Kazan, Russian Federation

Abstract

Background Oral glucocorticoids (GC) are used in different medicine fields and appear as risk factors of glucocorticoid-induced osteoporosis (GIO).

Objectives The aim is to estimate the frequency of use of prophylaxis of OP, use drugs that are approved for GIO and also an awareness of GIO of patients with prolonged intake of GC.

Methods 50 patients (10 men and 40 women), taking GC, took part in research. 30 patients (60%) were from rheumatology department, 5 patients (10%) from pulmonology department, 5 patients (10%) from gastroenterology department, 10 patients (20%) from nephrology department of Republic Clinical Hospital. Mean age of patients - 48,84±14,03 years (from 26 to 73). The following signs were estimated: clinical data, osteoporosis risk factors, instrumental tests (X-ray, densitometry). FRAX assessment of fracture risk was performed, the questionnaires of patients' awareness of GIO was completed.

Results The duration of intake GC – 5,93±4,86 years. Minimal dose of GC per day (if receiving prednisone) – 7.5 mg; maximal dose – 60 mg. 10-year risk of major osteoporotic fractures by FRAX, adjusted according to GC dose - 18,11±11,01. 32 patients (64%) were given recommendations for changing lifestyle and diet for GIO prophylaxis, 40 patients (80%) - recommendations for intake of calcium and vitamin D medications, but only 31 patients (62%) followed recommendations and started the intake of calcium medications. From the said number of patients only 14 patients (45,2%) used appropriate daily dose of calcium and vitamin D.

Drugs that are approved for GIO were have to be prescribed for 18 patients, but only 6 patients (33,3%) underwent treatment, principally bisphosphonates. Only half of them underwent densitometry after starting the therapy. 72,2% patients with GIO used calcium and 30,7% were taking appropriate daily dose of calcium and vitamin D. 70% rheumatologic patients knew about GIO and in 90% cases calcium and vitamin D drugs were recommended. Only 50% of patients from non-rheumatologic departments knew about GIO and in 65% cases calcium and vitamin D drugs were recommended.

Conclusions Clinical recommendations in real clinical practice are rarely fulfilled. Less than 60% patients were taking calcium and vitamin D, which are recommended for all patients, who started the GC therapy; only 33% of patients received osteoporosis therapy, only half of them underwent densitometry. Patients are insufficiently informed about necessity of changing lifestyle and diet for GIO prophylaxis. Education for patients taking GC and training for rheumatologic and non-rheumatologic specialties are necessary.

Disclosure of Interest None declared

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