双能量X射线吸收度和抗骨质疏松症药物在澳大利亚早期类风湿性关节炎患者的使用,使用澳大利亚风湿病学协会数据库的数据
Andrea Lyon1,2, Susan Lester1,2, Jessica Stanhope1,3
1Rheumatology Unit, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia.
Internal medicine journal
|April 15, 2025
概括
尽管有指导方针,澳大利亚的类风湿性关节炎患者通过DEXA扫描进行骨质疏松症查延迟了. 及时查和治疗对于管理这群人中骨折风险至关重要.
科学领域:
- 类风湿病学 类风湿病学
- 内分泌学 在内分泌学.
- 公共卫生 公共卫生
背景情况:
- 类风湿性关节炎 (RA) 显著增加骨质疏松症的风险.
- 澳大利亚的指导方针建议对RA患者进行定期骨折风险评估.
- 早期发现和治疗骨质疏松症对于减少骨折负担至关重要.
研究的目的:
- 评估使用双能X射线吸收仪 (DEXA) 在早期RA患者骨质疏松症查中的使用情况.
- 分析澳大利亚RA患者的抗骨质疏松症药物发行模式.
- 确定影响DEXA查和治疗开始的因素.
主要方法:
- 分析了来自306名澳大利亚风湿病学协会数据库 (ARAD) 参与者的数据,这些参与者从2011年起被诊断为RA.
- 使用了链接医疗保险福利计划和制药福利计划数据 (2011-2023年).
- 卡普兰-梅尔和考克斯回归模型评估了DEXA和药物发放的时间,控制共变量.
主要成果:
- 第一次DEXA扫描的中位时间是RA诊断后3年.
- 德克萨的预测因素包括女性性别,年龄≥50,和葡萄糖皮质激素的使用;较低的概率与BMI≥25.
- 8年后,25%的人接受了抗骨质疏松症药物,预测年龄≥50岁和使用葡萄糖皮质激素.
结论:
- 在RA患者的骨质疏松症查中存在显著的延迟和变化.
- 查实践受到年龄,葡萄糖皮质激素使用和BMI的影响,这表明在护理方面的差距.
- 需要标准化协议,以确保及时进行DEXA扫描,并改善RA患者的骨质疏松症管理.
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