title: Prescription for antiresorptive therapy in Mexican patients with rheumatoid arthritis: is it time to reevaluate the strategies for osteoporosis prevention?
abstract: Glucocorticoids are frequently used in rheumatoid arthritis (RA) in order to alleviate symptoms of joint inflammation, retard erosions and to treat extra-articular manifestations, although these drugs may increase the risk of bone mineral loss and osteoporotic fractures. To date, in Mexico there are no studies that identify the frequency of patients with RA with corticosteroids, receiving therapy for osteoporosis. Therefore, we evaluated the prevalence and factors related to the prescription of antiresorptives in 520 Mexican patients with RA. We used a multivariate model to identify variables associated with antiresorptives prescription. We identified that although 79% of patients were under treatment with glucocorticoids, only 13% received antiresorptive agents as preventive therapy for osteoporosis. The multivariate analysis identified that higher proportions of antiresorptive drugs prescriptions were associated with female patients (OR 11.40, 95% CI: 1.5-84.3, P = 0.02), an age of 40 years or more (OR 3.22, 95% CI: 1.3-8.3, P = 0.02) and to consume a lower number of cointerventions with other drugs (OR 1.09, 95% CI: 1.0-1.2, P = 0.03). Corticosteroid treatment was not associated with the prescription of antiresorptives (P = 0.31). In conclusion, a low proportion of Mexicans with RA receive antiresorptive therapy independently regardless of whether they consume or not chronically corticosteroids. Additional strategies should be evaluated to encourage the prevention and early treatment for osteoporosis in patients with RA.
authors.affiliation: Unidad de Investigación en Epidemiología Clínica, Instituto Mexicano del Seguro Social (IMSS) Hospital de Especialidades Centro Médico Nacional de Occidente, Guadalajara, Mexico.
authors.forename: J I
authors.initials: JI
authors.lastname: Gamez-Nava
authors.forename: S A
authors.initials: SA
authors.lastname: Zavaleta-Muñiz
authors.forename: M L
authors.initials: ML
authors.lastname: Vazquez-Villegas
authors.forename: A
authors.initials: A
authors.lastname: Vega-Lopez
authors.forename: N A
authors.initials: NA
authors.lastname: Rodriguez-Jimenez
authors.forename: E M
authors.initials: EM
authors.lastname: Olivas-Flores
authors.forename: N G
authors.initials: NG
authors.lastname: Gonzalez-Montoya
authors.forename: E G
authors.initials: EG
authors.lastname: Corona-Sanchez
authors.forename: A D
authors.initials: AD
authors.lastname: Rocha-Muñoz
authors.forename: M E
authors.initials: ME
authors.lastname: Martinez-Corral
authors.forename: B T
authors.initials: BT
authors.lastname: Martin-Márquez
authors.forename: M
authors.initials: M
authors.lastname: Vazquez-Del Mercado
authors.forename: J F
authors.initials: JF
authors.lastname: Muñoz-Valle
authors.forename: E G
authors.initials: EG
authors.lastname: Cardona-Muñoz
authors.forename: A
authors.initials: A
authors.lastname: Celis-De La Rosa
authors.forename: C
authors.initials: C
authors.lastname: Cabrera-Pivaral
authors.forename: L
authors.initials: L
authors.lastname: Gonzalez-Lopez
mesh_terms: D000328:Adult; D018501:Antirheumatic Agents / Q000009:adverse effects*; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D001862:Bone Resorption / Q000517:prevention & control*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004359:Drug Therapy, Combination; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications / Q000453:epidemiology / Q000517:prevention & control*; D015995:Prevalence; D012737:Sex Factors
chemical_list: D018501:Antirheumatic Agents; D050071:Bone Density Conservation Agents; D005938:Glucocorticoids