Quality assurance study of the use of preventative therapies in glucocorticoid-induced osteoporosis in early inflammatory arthritis: results from the CATCH cohort
| Autor: | Emily, McKeown, Vivian P, Bykerk, Faye, De Leon, Ashley, Bonner, Carter, Thorne, Carol A, Hitchon, Gilles, Boire, Boulos, Haraoui, Diane S, Ferland, Edward C, Keystone, Janet E, Pope, Vivian, Bykerk |
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| Rok vydání: | 2012 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Databases Factual Quality Assurance Health Care medicine.medical_treatment Inflammatory arthritis Osteoporosis Arthritis Arthritis Rheumatoid Cohort Studies Rheumatology Prednisone Interquartile range Internal medicine Vitamin D and neurology Medicine Humans Pharmacology (medical) Vitamin D Glucocorticoids Bone Density Conservation Agents business.industry Early Inflammatory Arthritis Bisphosphonate Middle Aged medicine.disease Endocrinology Disease Progression Calcium Drug Therapy Combination Female business medicine.drug |
| Zdroj: | Rheumatology (Oxford, England). 51(9) |
| ISSN: | 1462-0332 |
| Popis: | Objective. To characterize steroid use and compliance with glucocorticoid-induced osteoporosis (GIOP) guidelines within a large early inflammatory arthritis cohort. Methods. Using the Canadian Early Arthritis Cohort (CATCH) database, patients with inflammatory arthritis on glucocorticoids (oral, IA and i.m.) were identified. Consecutive steroid exposure was defined as using glucocorticoids for two consecutive clinic visits (at least 90 days apart). The primary outcome was the proportion of patients receiving calcium, vitamin D and a bisphosphonate among patients treated with consecutive oral glucocorticoids. Results. Six hundred and fifty-five patients were in the CATCH database, where 273 patients were identified as glucocorticoid users, of whom 48% were on oral prednisone, 38% received i.m. or IA and 13% both. The median oral daily dose of prednisone was 5 mg (interquartile range 2.510). Consecutive users (CUs, n = 78) compared with non-consecutive users (NUs, n = 532) showed that CUs were older (56 vs 50 years, P = 0.001); females were fewer (63% vs 74%, P = 0.04), but a similar proportion were RF positive (51% in CU vs 56% in NU, P = 0.73). For the primary outcome, rates of prophylaxis for users of consecutive oral steroids were as follows: 53% were treated with calcium, 47% with vitamin D and 25% were on a bisphosphonate. For users of oral prednisone at doses 57.5 mg/day, rates of prophylaxis were as follows: 64% were treated with calcium, 57% with vitamin D and 21% were on a bisphosphonate. Conclusion. Glucocorticoid therapy is frequently used in early inflammatory arthritis. The use of calcium, vitamin D or a bisphosphonate was low among chronic glucocorticoid users and illustrates the need for more diligence in patients receiving glucocorticoids to prevent GIOP. |
| Databáze: | OpenAIRE |
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