对葡萄糖皮质醇诱导骨质疏松症治疗的不同干预值进行比较:一个横截面研究

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Kanchalee Puksun¹, Chatlert Pongchaiyakul², Rattapol Pakchotanon¹

¹Rheumatic Disease Unit, Department of Internal Medicine, Phramongkutklao Hospital and College of Medicine, 315 Rajavithi road, Rajathevee district, Bangkok, 10400, Thailand.

BMC rheumatology

|April 2, 2025

概括

葡萄糖皮质醇诱导的骨质疏松症 (GIO) 治疗指南各不相同. 在ACR 2022,韩国2018和日本2023指南中,GIO的敏感度很高,而马来西亚2015指南在治疗类风湿病患者方面提供了最佳的特异性和准确性.

科学领域:

类风湿病学类风湿病学
内分泌学在内分泌学.
骨质疏松症研究骨质疏松症研究

背景情况:

葡萄糖皮质醇诱导的骨质疏松症 (GIO) 是一种常见的药物诱导疾病.
早期检测和治疗对于预防脆弱性骨折至关重要.
现有的GIO指南为药理治疗提供了不同的干预门.

研究的目的:

从不同的GIO指南中评估干预门的表现.
为了比较各种指导方针在风湿患者中管理GIO的有效性.

主要方法:

对接受葡萄糖皮质类药物 (≥2.5 mg/天>3个月) 的类风湿患者的回顾性评估.
排除先前接受过抗骨质疏松治疗或二次骨质疏松原因的患者.
分析骨矿物质密度 (BMD) 和泰国特异性FRAX与葡萄糖皮质激素调整 (GC-FRAX).
对六个GIO指南 (ACR 2022,比利时 2022,TOPF 2021,韩国 2018,马来西亚 2015,日本 2023) 对脆弱性骨折发生率的评估.

主要成果:

研究包括226名风湿患者 (平均年龄62.9岁,88.9%为女性).
大型骨质疏松性骨折的患病率为14.2%.
在ACR 2022,韩国2018年和日本2023年指导方针中,显示了100%的灵敏度.
马来西亚2015年指南表现出最高的特异性 (62.9%) 和准确性 (65%).

结论:

根据ACR 2022,韩国2018年和日本2023年指导方针,对于GIO治疗的启动具有很高的敏感性.
马来西亚2015年指南为GIO管理提供了最高的具体性和准确性.
发现有助于优化风湿病患者GIO的临床决策.

关键词:

在FRAX分数中,FRAX的分数是:脆弱性骨折是一种脆弱性骨折.葡萄糖皮质类皮质类药物葡萄糖皮质醇诱导的骨质疏松症骨质疏松症是一种骨质疏松症.类风湿性疾病是一种类风湿性疾病.系统性自身免疫性疾病

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