Glucocorticoid‐induced osteoporosis: unawareness or negligence in India?

Gera, Chanchal; Vij, Amarjit Singh

doi:10.1111/j.1756-185x.2009.01415.x

Cited by 9 publications

(7 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These higher rates compared with our results may be ascribable to methodological differences. 14 16 22 25 A study of incident cases showed lower bisphosphonate prescription rates than in our population, of 8% overall and 16% in women over 55 years, compared with 12% and 24% in our study, respectively. Another study of all patients given glucocorticoid therapy also found a slightly lower rate, of 7%.…”

Section: Discussioncontrasting

confidence: 48%

Osteoporosis prevention among chronic glucocorticoid users: results from a public health insurance database

et al. 2016

View full text Add to dashboard Cite

IntroductionLong-term glucocorticoid therapy is the leading cause of secondary osteoporosis. The management of glucocorticoid-induced osteoporosis (GIOP) seems to be inadequate in many European countries.ObjectiveTo evaluate the rate of screening and treatment of GIOP.DesignInformation was collected from a national public health-insurance database in our geographic area of Provence-Alpes-Côte-d'Azur and in Corsica, from September 2009 through August 2011.PatientsWe identified participants aged 15 years and over starting glucocorticoid therapy (≥7.5 mg of prednisone equivalent per day during at least 90 days consecutive). This cohort was compared with an age-matched and sex-matched population that did not receive glucocorticoids.Main outcome measuresBone mass, prescription of bone antiresorptive medication and use of calcium and/or vitamin D treatment.ResultsWe identified 32 812 patients who were prescribed glucocorticoid therapy, yielding 1% prevalence. Incidence of glucocorticoid therapy was 2.8/1000 inhabitants/year. Males represented 44%, the mean age was 58 years. The median prednisone-equivalent dose was 11 mg/day (IQR 9–18 mg/day). 8% underwent bone mass measurement. Calcium and/or vitamin D, and bisphosphonates were prescribed in 18% and 12%, respectively. Results were lower for the control population: 3% underwent bone mass measurement and 3% received bisphosphonate therapy. The rates of osteodensitometry and treatments were higher in women over 55 years of age than in men and women 55 years of age and younger, and also when glucocorticoid therapy was initiated by a rheumatologist versus other physician specialty.ConclusionsThe management of GIOP remains very inadequate, despite the availability of a statutory health insurance system. Targeted interventions are needed to improve the management of GIOP.

show abstract

Section: Discussioncontrasting

confidence: 48%

Osteoporosis prevention among chronic glucocorticoid users: results from a public health insurance database

et al. 2016

View full text Add to dashboard Cite

show abstract

“…How much filters into the front line workers and their subsequent response can sometimes be cause for concern. Consequently, several studies have been undertaken to assess health care professionals' attitudes towards osteoporosis (10)(11)(12)(13)(14)(32)(33)(34)(35)(36).…”

Section: Discussionmentioning

confidence: 99%

Osteoporosis and its management: Knowledge, attitudes and practices of physicians in United Arab Emirates

Beshyah

Mehri

Khalil

2013

Ibnosina Journal of Medicine and Biomedical Sciences

View full text Add to dashboard Cite

Background: Awareness among physicians is essential for early detection and timely treatment. Aim: To assess physicians' attitudes and knowledge to management of osteoporosis. Methods: A descriptive study using a questionnaire. The group studied consisted of a convenience sample of hospital and primary care physicians in the United Arab Emirates. Results: Responses were obtained from 173 physicians (49.7% female, 50.2% male). Over half were senior physicians (87) with the majority practicing in public institutions (158). The majority of the respondents thought that osteoporosis was an important clinical problem, and appreciated the fact that women in the Middle East are at an increased risk of osteoporosis. They thought that antiosteoporosis management should be covered by national medical insurance schemes. However, more than 75% were unaware of the presence of regional guidelines on osteoporosis. Many respondents recognized the frequency and importance of vitamin D deficiency in non-skeletal health issues, though not all realized the need for higher doses in people with lower levels of sun exposure. A high proportion of respondents encouraged physical activity and cessation of smoking for all women. However, their use of medications was variable and not compatible with current guidelines. A relatively low level of knowledge was found regarding adequate dosing of several pharmacological treatments. Conclusions: Gaps in knowledge of physicians about bone health were identified. There is a need to extend medical knowledge regarding the contemporary management of osteoporosis and its risk factors.

show abstract

“…Although a variety of genomic and nongenomic mechanisms of glucocorticoids provides the suppression of the inflammatory response, the dose escalation and the long-term systemic administration of these drugs lead to a number of well-characterized clinical side effects, such as brittle skin [33], muscle weaknesses, osteoporosis [34], fat redistribution [35], diabetes [36], and neurodegeneration or suppressed neurogenesis in the brain [37]. The development of delivery systems of these drugs represents a therapeutic alternative, with fewer side effects, to effectively control of inflammation and immunosuppressive responses, as well as angiogenesis [38].…”

Section: Introductionmentioning

confidence: 99%

Controlled release of triamcinolone acetonide from polyurethane implantable devices: application for inhibition of inflammatory-angiogenesis

Pinto

Cunha

Oréfice

et al. 2012

J Mater Sci: Mater Med

View full text Add to dashboard Cite

The purpose of this study was to develop triamcinolone acetonide-loaded polyurethane implants (TA PU implants) for the local treatment of different pathologies including arthritis, ocular and neuroinflammatory disorders. The TA PU implants were characterized by FTIR, SAXS and WAXS. The in vitro and in vivo release of TA from the PU implants was evaluated. The efficacy of TA PU implants in suppressing inflammatory-angiogenesis in a murine sponge model was demonstrated. FTIR results revealed no chemical interactions between polymer and drug. SAXS results indicated that the incorporation of the drug did not disturb the polymer morphology. WAXS showed that the crystalline nature of the TA was preserved after incorporation into the PU. The TA released from the PU implants efficiently inhibited the inflammatory-angiogenesis induced by sponge discs in an experimental animal model. Finally, TA PU implants could be used as local drug delivery systems because of their controlled delivery of TA.

show abstract

Glucocorticoid‐induced osteoporosis: unawareness or negligence in India?

Abstract: The study shows poor pre-therapeutic risk assessment, absence of instructions regarding preventive measures, inappropriate investigation for presence of osteoporosis, and unacceptable absence of bone protective agents.

Cited by 9 publications

References 10 publications

Osteoporosis prevention among chronic glucocorticoid users: results from a public health insurance database

Osteoporosis prevention among chronic glucocorticoid users: results from a public health insurance database

Osteoporosis and its management: Knowledge, attitudes and practices of physicians in United Arab Emirates

Controlled release of triamcinolone acetonide from polyurethane implantable devices: application for inhibition of inflammatory-angiogenesis

Contact Info

Product

Resources

About