Open Access Open Access  Restricted Access Subscription Access
Open Access Open Access Open Access  Restricted Access Restricted Access Subscription Access

A one Year Study of the Adequacy of Primary Prophylaxis in Prevention of Glucocorticoid-induced Osteoporosis in Rural Western Uttar Pradesh


Affiliations
1 Department of Pediatrics, Saraswathi Institute of Medical Sciences, Hapur, Ghaziabad, U.P., India
2 Department of Medicine, Saraswathi Institute of Medical Sciences, Hapur, Ghaziabad, U.P, India
3 Department of Orthopedics, Saraswathi Institute of Medical Sciences, Hapur, Ghaziabad, U.P., India
     

   Subscribe/Renew Journal


Introduction: Fragility fractures are well known&serious complication of long-term treatment with corticosteroids. Glucocorticoid-induced osteoporosis (GIOP) is characterized by rapid bone loss and increased fracture risk in the early stages of beginning of therapy and is amenable to proper preventive measures. Thus, glucocorticoid-induced bone loss should be treated aggressively. The aim of this study is to probe the adequacy of primary prophylaxis for glucocorticoid-induced osteoporosis (GIOP) in patients taking long-term steroids.

Methods: A retrospective study was conducted in our institute to assess treating doctor's awareness and preventive measures taken during treatment against GIOP. Hospital records of patients receiving > 7.5 mg/day of oral steroids for > 3 months were studied and relevant data was collected. Primary preventive measures instituted against GIOP were noted and the data was analyzed.

Results: Two hundred and three patients, 121 females and 82 males, fulfilling the inclusion criteria were included in this study. Of the 203 patients, 61 did not receive any prophylaxis, 97 received inadequate prophylaxis and only 45 were given appropriate prophylaxis.

Conclusions: The awareness about instituting primary preventive measures against GIOP among treating doctors is highly unsatisfactory. There is an urgent need to increase awareness and knowledge of GIOP management. There are effective strategies for prevention and treatment of GIOP&these should be used aggressively in such patients.


Keywords

Steroids, Glucocorticoid-Induced Osteoporosis (GIOP), Prophylaxis
Subscription Login to verify subscription
User
Notifications
Font Size


  • van Staa TP, Leufkens HGM, Cooper C. The epidemiology of corticosteroid-induced osteoporosis: a meta-analysis. Osteoporos Int 2002; 13:777-787.
  • Compston J. Management of glucocorticoidinduced osteoporosis. Nat Rev Rheumatol 2010; 6: 82–88.
  • Royal College of Physicians. Glucocorticoidinduced osteoporosis. Guidelines on prevention and treatment. Bone and Tooth Society of Great Britain, National Osteoporosis Society and Royal College of Physicians. London UK: Royal College of Physicians, 2002.
  • Newman ED, Matzko CK, Olenginski TP, Perruquet JL, Harrington TM, Maloney-Saxon G, Culp T, Wood GC. Glucocorticoid-induced osteoporosis program (GIOP): a novel, comprehensive and highly successful care program with improved outcomes at 1 year. Osteoporos Int 2006; 17: 1428–1434.
  • American College of Rheumatology 2010 Recommendations for the Prevention and Treatment of Glucocorticoid-Induced Osteoporosis: Arthritis Care & Research ,Vol. 62, No. 11, November 2010, pp 1515–1526.
  • Evange Romas: Corticosteroid-induced osteoporosis and fractures: Aust Prescr 2008; 31:45-49
  • Reid IR, Heap SW. Determinants of vertebral mineral density in patients receiving long term glucocorticoid therapy. Arch Intern Med 1990; 150:2545–2548.
  • Dykman TR, Gluck OS, Murphy WA, Hahn TJ, Hahn BH. Evaluation of factors associated with glucocorticoid-induced osteopenia in patients with rheumatic diseases. Arthritis Rheum 1985; 28: 361–368.
  • Leufkens HGM, van Staa TP, Cooper C. The epidemiology of corticosteroid-induced osteoporosis: a meta-analysis. Osteoporos Int 2002; 13:777-787.
  • Selby PL, Halsey JP, Adams KRH, et al. Corticosteroids do not alter the threshold for vertebral fracture. J Bone Miner Res 2000; 15: 952–956.
  • Luengo M, Picado C, Del Rio L, Guanabens N, Montserrat JM, Setoain J. Vertebral fractures in steroid dependant asthma and involutional osteoporosis: a comparative study. Thorax 1991; 46: 803–806.
  • Adler RA, Hochberg MC. Suggested guidelines for evaluation and treatment of glucocorticoidinduced osteoporosis for the Department of Veterans Affairs. Arch Intern Med 2003; 163: 2619–2624.
  • National Osteoporosis Society. Guidelines on the prevention and management of corticosteroidinduced osteoporosis. London: NOS, 1998.
  • Eastell R, Reid DM, Compston J, Cooper C, Fogelman I, Francis RM, et al. A UK consensus group on management of Glucocorticoid-induced osteoporosis. An update. J intern Med 1998; 244: 271–292.
  • Saag KG, Shane E, Boonen S, Marín F, Donley DW, Taylor KA, et al. Teriparatide or Alendronate in glucocorticoid-induced osteoporosis. N Engl J Med 2007; 357: 2028–2039.
  • Gera C, Vij AS. Glucocorticoid-induced osteoporosis: unawareness or negligence in India? Int J Rheum Dis 2009; 12: 230–233.
  • Sadat-Ali M, Alelq AH, Alshafei BA, Al-Turki HA, Abujubara MA. Osteoporosis prophylaxis in patients receiving chronic glucocorticoid therapy. Ann Saudi Med 2009; 29: 215–218.
  • Ungprasert S, Wangkaew S, Louthrenoo W. Physician’s awareness of the prevention of corticosteroid induced osteoporosis. J Med Assoc Thai 2007; 90: 59–64.
  • Nagaraj Srinivasulu et al: Primary prophylaxis for steroid-induced osteoporosis .Indian Journal of Rheumatology, Volume 5, Issue 4,176-179 (December 2010)
  • Bhatnagar T, Mishra CP, Mishra RN. Drug prescription practices: a household study in rural Varanasi. Indian J Prev Soc Med 2003; 34: 34–9.
  • George R, Abraham R. Private health in India. Lancet 2002; 359: 1528.
  • Hart SR, Green B. Osteoporosis prophylaxis during corticosteroid treatment: failure to prescribe. Post grad Med J 2002; 78: 242–243.

Abstract Views: 338

PDF Views: 0




  • A one Year Study of the Adequacy of Primary Prophylaxis in Prevention of Glucocorticoid-induced Osteoporosis in Rural Western Uttar Pradesh

Abstract Views: 338  |  PDF Views: 0

Authors

Bhawna Kohli
Department of Pediatrics, Saraswathi Institute of Medical Sciences, Hapur, Ghaziabad, U.P., India
Anil Kumar Kem
Department of Medicine, Saraswathi Institute of Medical Sciences, Hapur, Ghaziabad, U.P, India
Rajesh Bhatia
Department of Orthopedics, Saraswathi Institute of Medical Sciences, Hapur, Ghaziabad, U.P., India

Abstract


Introduction: Fragility fractures are well known&serious complication of long-term treatment with corticosteroids. Glucocorticoid-induced osteoporosis (GIOP) is characterized by rapid bone loss and increased fracture risk in the early stages of beginning of therapy and is amenable to proper preventive measures. Thus, glucocorticoid-induced bone loss should be treated aggressively. The aim of this study is to probe the adequacy of primary prophylaxis for glucocorticoid-induced osteoporosis (GIOP) in patients taking long-term steroids.

Methods: A retrospective study was conducted in our institute to assess treating doctor's awareness and preventive measures taken during treatment against GIOP. Hospital records of patients receiving > 7.5 mg/day of oral steroids for > 3 months were studied and relevant data was collected. Primary preventive measures instituted against GIOP were noted and the data was analyzed.

Results: Two hundred and three patients, 121 females and 82 males, fulfilling the inclusion criteria were included in this study. Of the 203 patients, 61 did not receive any prophylaxis, 97 received inadequate prophylaxis and only 45 were given appropriate prophylaxis.

Conclusions: The awareness about instituting primary preventive measures against GIOP among treating doctors is highly unsatisfactory. There is an urgent need to increase awareness and knowledge of GIOP management. There are effective strategies for prevention and treatment of GIOP&these should be used aggressively in such patients.


Keywords


Steroids, Glucocorticoid-Induced Osteoporosis (GIOP), Prophylaxis

References