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Are glucocorticoid-induced osteoporosis recommendations sufficient to determine antiosteoporotic treatment for patients with rheumatoid arthritis?

Title
Are glucocorticoid-induced osteoporosis recommendations sufficient to determine antiosteoporotic treatment for patients with rheumatoid arthritis?
Author
배상철
Keywords
Glucocorticoids; Osteoporosis; Arthritis; rheumatoid; Guideline
Issue Date
2014-07
Publisher
대한내과학회(The Korean Association Of Internal Medicine)
Citation
The Korean Journal of Internal Medicine, 2014, 29(4), P.509-515
Abstract
Background/Aims: We investigated diff erences in identifying candidates for antiosteoporotic treatment in rheumatoid arthritis (RA) patients according to two available clinical guidelines. Methods: We prospectively enrolled 100 female patients aged 50 years or older with RA who visited Hanyang University Hospital for periodic examinations between April 2011 and August 2011. We applied the glucocorticoid-induced osteoporosis (GIOP) recommendations and the National Osteoporosis Foundation (NOF) guidelines to RA patients and examined agreement between the guidelines for identifying candidates for antiosteoporotic treatment. We also analyzed the impact of screening vertebral fractures (VFs) in determining the treatment of osteoporosis in RA patients. Results: The 57 patients taking glucocorticoids were classified into high-risk (n = 23), medium-risk (n = 16), and low-risk (n = 18) groups according to the GIOP recommendations. Based on the NOF guidelines, 36 of 57 patients were candidates for antiosteoporotic treatment and the agreement between two guidelines was high ( = 0.76). Two of the 18 patients in the low-risk group and 19 of 43 patients not eligible per the GIOP recommendations were classified as candidates for antiosteoporotic treatment by the NOF guidelines. Conclusions: In determining antiosteoporotic treatment for RA patients, using only the GIOP recommendations is insufficient. Application of the NOF guidelines in patients not eligible for or classifi ed into the low-risk group per the GIOP recommendations and screening for VFs may be helpful in deciding on antiosteoporotic treatment in RA patients.
URI
http://kjim.org/journal/view.php?doi=10.3904/kjim.2014.29.4.509
ISSN
1226-3303; 2005-6648
DOI
10.3904/kjim.2014.29.4.509
Appears in Collections:
COLLEGE OF MEDICINE[S](의과대학) > ETC
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