The glucocorticoid-induced osteoporosis (GIOP)
Osteoporosis is most commonly observed in elderly and is a leading cause of fractures as they become fragile and weak. Long-term glucocorticoid therapy is the chief cause of secondary osteoporosis. In many European countries, management of glucocorticoid-induced osteoporosis (GIOP) seems to be inadequate. A study was performed to estimate the rate of screening and treatment of GIOP.
The information for same was retrieved from a national public health-insurance database in the geographic area of Provence-Alpes-Côte-d’Azur and in Corsica, from September 2009 through August 2011. Participants over 15 years and over starting glucocorticoid therapy were spotted. This cohort was collated with an age-matched and sex-matched population that did not sustain glucocorticoids. Main outcome measures contained bone mass, prescription of bone antiresorptive medication and use of calcium and/or vitamin D treatment.
As a result, 32 812 patients were identified who had glucocorticoid therapy, yielding 1% prevalence. The occurrence of glucocorticoid therapy was 2.8/1000 inhabitants/year. The mean age was 58 years with 44% males. Median prednisone-equivalent dose was 11 mg/day (IQR 9–18 mg/day) and total 8% undergo bone mass measurement. Calcium and/or vitamin D, and bisphosphonates were advised in 18% and 12%, respectively. Total 3% underwent bone mass measurement and 3% attained bisphosphonate therapy with lower outcomes for the control population. The measures of osteodensitometry and treatments were higher in women over 55 years of age than in men and women 55 years of age and younger, and also when glucocorticoid therapy was commenced by a rheumatologist versus other physician specialty.
Thus, it can be concluded that the GIOP management remains very inadequate, despite the availability of a statutory health insurance system. To ameliorate the management of GIOP, targeted interventions are required.