Vitamin D and bisphosphonate therapy in systemic lupus erythematosus patients who receive glucocorticoids: are we offering the best care?

Autor:	S Sapkota, A M O'Connell, T Hess, Jeremiah S Menk, Pouneh K. Fazeli, A Shmagel, M Shyne, S Baig, K Ensrud
Rok vydání:	2020
Předmět:	Adult Male medicine.medical_specialty Minnesota Osteoporosis 030209 endocrinology & metabolism Young Adult 03 medical and health sciences 0302 clinical medicine Rheumatology Risk Factors Internal medicine medicine Vitamin D and neurology Humans Lupus Erythematosus Systemic Vitamin D Glucocorticoids Management practices Retrospective Studies 030203 arthritis & rheumatology Bone Density Conservation Agents Diphosphonates business.industry Vitamins Middle Aged medicine.disease Prednisone Female Bisphosphonate therapy business Osteoporotic Fractures Glucocorticoid medicine.drug
Zdroj:	Lupus. 29:263-272
ISSN:	1477-0962 0961-2033
DOI:	10.1177/0961203320903086
Popis:	Objective This study aimed to evaluate management practices for glucocorticoid (GC)-induced osteoporosis (GIOP) in systemic lupus erythematosus (SLE) patients using 2017 American College of Rheumatology guidelines as a gold standard. Methods We conducted a retrospective cohort study using a clinical database from the years 2011 to 2016. SLE cases with >90 days continuous prednisone use at doses of ≥7.51 mg daily were identified. Osteoporosis risk factors were assessed via chart review. The Fracture Risk Assessment (FRAX) score was estimated for patients > 40 years of age. Vitamin D, bisphosphonate prescriptions, and osteoporotic (OP) fractures were ascertained through chart review. A classification tree was used to identify the key patient-related predictors of bisphosphonate prescription. Results A total of 203 SLE patients met the inclusion criteria. The recommended dose of vitamin D supplement was prescribed to 58.9% of patients Conclusions In clinical practice, fewer SLE patients with or at risk for GIOP are prescribed vitamin D and bisphosphonates than recommended by the 2017 ACR guidelines. Also, in this study, another 10% were prescribed a bisphosphonate, despite not having an indication per the ACR guidelines. Patients were most likely to receive a bisphosphonate prescription if they had a major OP FRAX score of > 23.5%.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::7c5b2e89285e8b527181cf641c304cec https://doi.org/10.1177/0961203320903086 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
Nepřihlášeným uživatelům se plný text nezobrazuje	K zobrazení výsledku je třeba se přihlásit.