Prevention, diagnosis, and treatment of glucocorticoid induced osteoporosis by rheumatologists in a Latin-American city.
OBJECTIVE
To examine current practices for the diagnosis and therapy for glucocorticoid-induced osteoporosis (GIOP) in patients under treatment with corticosteroids at outpatient clinics of rheumatologists in a Colombian Caribbean city.


METHODS
All patients noted to be using of glucocorticoids (GC) on an index consult from February to May 2004 were included in a descriptive cross sectional study. Criteria for inclusion of patients were to have had, at least, one previous visit to the service. We evaluated the study population for osteoporosis diagnosis, procedures, and treatment.


RESULTS
Of the 121 patients included, 103 (85.1%) were female and 18 (14.9%) were male; 76 patients (62.8%) were under 50 years, and 45 (37.2%) were over 50 years. Main reasons for corticosteroid use were rheumatoid arthritis in 68 patients (56.2%) and systemic lupus erythematous (SLE) in 31 patients (25.6%). Diagnostic testing for osteoporosis was reported on 50.1% of patients. Peripheral dual energy x-ray absorptiometry was the most frequently used method (52.6%). Therapeutic agents for GIOP were used in 96 patients (79.3%), with Calcium plus Vitamin D (55.2%) the principal treatments prescribed.


CONCLUSIONS
We found similar rates of diagnosis and treatment for GIOP to those reported in North America and Europe, although in this study treatment was mainly with calcium and vitamin D. There was a statistically significant relationship between being studied with any diagnostic method and being treated for GIOP. There may be undertreatment for GIOP in Latin America. Local interventions to improve care for patients in chronic use of steroids are needed.
Caballero-Uribe
Carlo V
CV
Rheumatology Unit, Universidad del Norte, Barranquilla, Colombia, South America. carvica@gmail.com
Acosta-Velez
Juan G
JG
Hernandez-Ruiz
Eder A
EA
Andrade Rodado
Fernando M
FM
Peñuela-Epalza
Martha
M
D015502:Absorptiometry, Photon; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D003105:Colombia; D003430:Cross-Sectional Studies; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D010024:Osteoporosis / Q000139:chemically induced* / Q000175:diagnosis / Q000517:prevention & control; D012216:Rheumatic Diseases / Q000188:drug therapy*
D050071:Bone Density Conservation Agents; D005938:Glucocorticoids