High-dose corticosteroid exposure and osteoporosis intervention in adults

Che, Maggie; Ettinger, Bruce; Nguyen, Myngoc T.; Pressman, Alice; Johnston, Jennifer

doi:10.1016/s1081-1206(10)60941-6

Cited by 4 publications

(1 citation statement)

References 19 publications

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“…In particular, the Korean GIOP guideline (KSBMR/KCR guideline) proposed that fracture risk assessment, such as the Fracture Risk Assessment Tool, should be performed for adults who are using or planning to receive GC therapy. However, it has been suggested that there is a considerable gap in the prevention and treatment of GIOP in real-world practice [3,[10][11][12][13][14][15][16][17][18][19]. Existing data on the status of GIOP prevention have been mostly focused on Western countries, and studies on Asians, especially Koreans, are lacking.…”

Section: Introductionmentioning

confidence: 99%

Status of Glucocorticoid-Induced Osteoporosis Preventive Care in Korea: A Retrospective Cohort Study on the Korean National Health Insurance Service Database

Song

Kim

et al. 2022

Medicina

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Background and Objectives: It is crucial to prevent osteoporosis in patients receiving long-term glucocorticoid (GC) treatment. This study aimed to investigate the frequency and associated factors of preventive care for glucocorticoid-induced osteoporosis (GIOP) in Korea. Materials and Methods: Using the Korean National Health Insurance Service database, we identified 37,133 individuals aged ≥ 20 years who commenced long-term (≥90 days) oral GC between 2011 and 2012. High-quality GIOP preventive care was defined as either a bone mineral density (BMD) test, calcium and/or vitamin D supplementation, or prescription osteoporosis medications within 6 months of GC initiation. Multivariable logistic regression models were used to calculate odds ratios (ORs) for associated factors for high-quality GIOP preventive care. Results: The mean age was 49.8 years, and 18,476 (49.8%) patients were female. The frequency of high-quality GIOP preventive care was only 3.68% (BMD test, 1.46%; osteoporosis medications, 1.65%; calcium/vitamin D, 1.63%). Increasing age (OR = 2.53, p < 0.001; 40–49 years, OR = 3.99, p < 0.001; 50–59 years, OR = 5.17, p < 0.001; 60–69 years, OR = 8.07, p < 0.001; ≥70 years, respectively), systemic autoimmune disease (OR = 3.08, p < 0.001), rural residence (OR = 1.19, p = 0.046), concomitant hyperthyroidism (OR = 1.58, p = 0.007), and malignancy (OR = 1.59, p < 0.001) were significantly associated with a higher likelihood of receiving high-quality GIOP preventive care. Male sex (OR = 0.26, p < 0.001) and GC prescription in primary care clinics and nursing hospitals (OR = 0.66, p < 0.001) were associated with a lower rate of high-quality GIOP preventive care. Conclusions: Most Korean patients treated with GC did not receive appropriate preventive care for GIOP in real-world practice. More efforts are needed by clinicians to prevent, screen, and treat GIOP.

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Section: Introductionmentioning

confidence: 99%

Status of Glucocorticoid-Induced Osteoporosis Preventive Care in Korea: A Retrospective Cohort Study on the Korean National Health Insurance Service Database

Song

Kim

et al. 2022

Medicina

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Guideline adherence by physicians for management of glucocorticoid-induced osteoporosis in Japan: a nationwide health insurance claims database study

et al. 2022

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Incidence and prevalence of medication-induced osteoporosis: evidence-based review

Allport¹

2008

Current Opinion in Rheumatology

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(1) While a number of medications have been shown to induce bone loss, the actual incidence and prevalence of medication-induced osteoporosis has not been well quantified. (2) Oral corticosteroids contribute to an increased prevalence of osteoporosis and an increased incidence of fracture in a number of different populations. The increased incidence of fracture in patients receiving inhaled corticosteroids for respiratory disease may be attributed to disease pathogenesis rather than the effects of medication. (3) Other therapies that increase the incidence and/or prevalence of medication-induced osteoporosis and fracture include androgen-deprivation therapy, aromatase inhibitors, protease inhibitors, selective serotonin reuptake inhibitors and prolactin-raising antiepileptic agents. (4) It is difficult to make definitive conclusions on the actual increase in the prevalence and/or incidence of osteoporosis in patients receiving certain medications, as values are often reported differently and studies are mainly retrospective and are therefore open to inherent selection biases and other confounders. Furthermore, there is little available information as to whether specific medications within a class are associated with a higher rate of bone disease than others.

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High-dose corticosteroid exposure and osteoporosis intervention in adults

Cited by 4 publications

References 19 publications

Status of Glucocorticoid-Induced Osteoporosis Preventive Care in Korea: A Retrospective Cohort Study on the Korean National Health Insurance Service Database

Status of Glucocorticoid-Induced Osteoporosis Preventive Care in Korea: A Retrospective Cohort Study on the Korean National Health Insurance Service Database

Guideline adherence by physicians for management of glucocorticoid-induced osteoporosis in Japan: a nationwide health insurance claims database study

Incidence and prevalence of medication-induced osteoporosis: evidence-based review

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