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Glucocorticoid-Induced Osteoporosis Prevention in Polymyalgia Rheumatica Patients
Irish Medical Journal
|August 21, 2020
Summary
Polymyalgia rheumatica (PMR) patients on glucocorticoids often lack bone protective therapy (BPT) for preventing osteoporosis. This study found many PMR patients are not optimally protected from glucocorticoid-induced osteoporosis (GIOP).
Area of Science:
- Rheumatology
- Endocrinology
- Bone Health
Background:
- Glucocorticoids are essential for polymyalgia rheumatica (PMR) but increase osteoporosis risk.
- Glucocorticoid-induced osteoporosis (GIOP) prevention guidelines recommend bone protective therapy (BPT).
- Studies suggest suboptimal BPT use in PMR patients.
Purpose of the Study:
- To assess GIOP protection in PMR patients.
- To evaluate bone densitometry (DXA) scan results, BPT use, and guideline adherence.
- To identify risk factors for bone density loss in PMR patients.
Main Methods:
- Retrospective chart review of PMR patients treated with glucocorticoids.
- Inclusion of patients who underwent DXA scans between 01/01/2016 and 27/10/2017.
- Analysis of BPT use, DXA results, and bone mineral density (BMD) changes over time.
Main Results:
- Out of 153 PMR patients, only 47.7% received BPT.
- A significant proportion had osteopenia (54.9%) or osteoporosis (17.6%) at DXA.
- Patients not on bisphosphonates showed a higher likelihood of BMD loss over time (p=0.022).
Conclusions:
- PMR patients treated with glucocorticoids are not optimally protected from GIOP.
- There is a gap between recommended BPT and actual prescription rates.
- Proactive bone protection strategies are crucial for PMR management.
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