Osteoporosis prophylaxis in patients receiving chronic glucocorticoid therapy.
OBJECTIVE
Glucocorticoid-induced osteoporosis (GIOP) is the most common form of secondary osteoporosis, yet few patients receive proper measures to prevent its development. We retrospectively searched prescription records to determine if patients receiving oral prednisolone were receiving prophylaxis or treatment for osteopenia and osteoporosis.


METHODS
Patients who were prescribed > or =7.5 milligrams of prednisolone for 6 months or longer during a 6- month period were identified through the prescription monitoring system. Demographic and clinical data were extracted from the patient records, and dual energy x-ray absorptiometry (DEXA) scans were retrieved, when available. Use of oral calcium, vitamin D and anti-resorptives was recorded.


RESULTS
One hundred males and 65 females were receiving oral prednisolone for a mean (SD) duration of 40.4 (29.9) months in males and 41.2 (36.4) months in females. Twenty-one females (12.7%) and 5 (3%) males had bone mineral density measured by DEXA. Of those, 10 (47.6%) females and 3 (50%) males were osteoporotic and 11(52.4%) females and 2 (40%) males were osteopenic. Calcium and vitamin D were prescribed to the majority of patients (60% to 80%), but none were prescribed antiresorptive/anabolic therapy.


CONCLUSIONS
Patients in this study were neither investigated properly nor treated according to the minimum recommendations for the management of GIOP. Physician awareness about the prevention and treatment of GIOP should be a priority for the local health care system.
Sadat-Ali
Mir
M
Department of Orthopedic Surgery, King Faisal University, Saudi Arabia. drsadat@hotmail.com
Alelq
Abdulmohsen H
AH
Alshafei
Badar A
BA
Al-Turki
Haifa A
HA
Abujubara
Mohammed A
MA
D015502:Absorptiometry, Photon; D000293:Adolescent; D000328:Adult; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D002118:Calcium / Q000627:therapeutic use*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000139:chemically induced / Q000175:diagnosis / Q000517:prevention & control*; D011239:Prednisolone / Q000009:adverse effects* / Q000627:therapeutic use; D012189:Retrospective Studies; D016896:Treatment Outcome; D014807:Vitamin D / Q000627:therapeutic use*; D014815:Vitamins / Q000627:therapeutic use*; D055815:Young Adult
D050071:Bone Density Conservation Agents; D005938:Glucocorticoids; D014815:Vitamins; D014807:Vitamin D; D011239:Prednisolone; D002118:Calcium