Skip to main content
Top
Published in: Osteoporosis International 10/2007

Open Access 01-10-2007 | Short Communication

Corticosteroid-induced osteoporosis prevention: longitudinal practice patterns in The Netherlands 2001–2005

Authors: M. Duyvendak, M. Naunton, J. Atthobari, P. B. van den Berg, J. R. B. J. Brouwers

Published in: Osteoporosis International | Issue 10/2007

Login to get access

Abstract

Summary

We investigated prevention trends and predictors for osteoporosis prevention in long term corticosteroid users. The use of bisphosphonates increased from 2001 to 2005. Longer duration of corticosteroid use and DMARD use were predictors for receiving prevention. Females appear reasonably well treated; however, men require more attention.

Introduction

Previous studies have shown that long-term corticosteroid users are undertreated for osteoporosis prevention. Our aim was to identify prevention trends in long-term corticosteroid users from 2001–2005 in The Netherlands and to identify predictors for bisphosphonate prophylaxis.

Methods

Pharmacy dispensing data were used from 9 community pharmacies. All oral corticosteroid doses were converted to “prednisolone equivalents”. We then identified long-term (≥90 days) corticosteroid episodes, which required bisphosphonate prophylaxis as per 2002 Dutch guidelines; Multivariate logistic regression was used to identify predictors for receiving prevention.

Results

We identified 615 different corticosteroid patients requiring prophylaxis. From 2001–2005 the use of bisphosphonates increased from 38% to 54% (p = 0.001). In 2005 females were prescribed more bisphosphonates than males (61% vs. 39%; p = 0.002), or any treatment (72% vs. 45%; p < 0.001). Multivariate analysis showed that longer duration of corticosteroid use and disease-modifying anti-rheumatic drug (DMARD) use were independent predictors of bisphosphonate use. Use of respiratory medication was a negative predictor of bisphosphonate use.

Conclusion

There has been a significant increase in osteoporosis prophylaxis in a population at high risk for osteoporosis/fractures. In particular, females appear reasonably well treated; however, men are still not receiving prevention to the same degree as women.
Literature
1.
go back to reference Canalis E, Bilezikian JP, Angeli A, Giustina A (2004) Perspectives on glucocorticoid-induced osteoporosis. Bone 34:593–598PubMedCrossRef Canalis E, Bilezikian JP, Angeli A, Giustina A (2004) Perspectives on glucocorticoid-induced osteoporosis. Bone 34:593–598PubMedCrossRef
2.
go back to reference Lukert BP, Raisz LG (1990) Glucocorticoid-induced osteoporosis: pathogenesis and management. Ann Intern Med 112:352–364PubMed Lukert BP, Raisz LG (1990) Glucocorticoid-induced osteoporosis: pathogenesis and management. Ann Intern Med 112:352–364PubMed
3.
go back to reference Curtis JR, Westfall AO, Allison JJ et al (2005) Longitudinal patterns in the prevention of osteoporosis in glucocorticoid-treated patients. Arthritis Rheum 52:2485–2494PubMedCrossRef Curtis JR, Westfall AO, Allison JJ et al (2005) Longitudinal patterns in the prevention of osteoporosis in glucocorticoid-treated patients. Arthritis Rheum 52:2485–2494PubMedCrossRef
4.
go back to reference Feldstein AC, Elmer PJ, Nichols GA, Herson M (2005) Practice patterns in patients at risk for glucocorticoid-induced osteoporosis. Osteoporos Int 16:2168–2174PubMedCrossRef Feldstein AC, Elmer PJ, Nichols GA, Herson M (2005) Practice patterns in patients at risk for glucocorticoid-induced osteoporosis. Osteoporos Int 16:2168–2174PubMedCrossRef
5.
go back to reference Naunton M, Peterson GM, Jones G, Griffin GM, Bleasel MD (2004) Multifaceted educational program increases prescribing of preventive medication for corticosteroid induced osteoporosis. J Rheumatol 31:550–556PubMed Naunton M, Peterson GM, Jones G, Griffin GM, Bleasel MD (2004) Multifaceted educational program increases prescribing of preventive medication for corticosteroid induced osteoporosis. J Rheumatol 31:550–556PubMed
6.
go back to reference Osteoporose Tweede Herziene Richtlijn [Osteoporosis, Second Revised Guideline] (2002) ISBN 90-76906-23-8, 2nd ed. Utrecht: Van Zuiden Communications B.V. Osteoporose Tweede Herziene Richtlijn [Osteoporosis, Second Revised Guideline] (2002) ISBN 90-76906-23-8, 2nd ed. Utrecht: Van Zuiden Communications B.V.
8.
go back to reference Saag KG, Gehlbach SH, Curtis JR, Youket TE, Worley K, Lange JL (2006) Trends in prevention of glucocorticoid-induced osteoporosis. J Rheumatol 33:1651–1657PubMed Saag KG, Gehlbach SH, Curtis JR, Youket TE, Worley K, Lange JL (2006) Trends in prevention of glucocorticoid-induced osteoporosis. J Rheumatol 33:1651–1657PubMed
9.
go back to reference van Staa TP, Leufkens HG, Abenhaim L, Begaud B, Zhang B, Cooper C (2000) Use of oral corticosteroids in the United Kingdom. QJM 93:105–111PubMedCrossRef van Staa TP, Leufkens HG, Abenhaim L, Begaud B, Zhang B, Cooper C (2000) Use of oral corticosteroids in the United Kingdom. QJM 93:105–111PubMedCrossRef
10.
go back to reference Walsh LJ, Wong CA, Pringle M, Tattersfield AE (1996) Use of oral corticosteroids in the community and the prevention of secondary osteoporosis: a cross sectional study. BMJ 313:344–346PubMed Walsh LJ, Wong CA, Pringle M, Tattersfield AE (1996) Use of oral corticosteroids in the community and the prevention of secondary osteoporosis: a cross sectional study. BMJ 313:344–346PubMed
11.
go back to reference Yood RA (2006) Prevention of glucocorticoid-induced osteoporosis: why are we doing so poorly? J Rheumatol 33:1461–1463PubMed Yood RA (2006) Prevention of glucocorticoid-induced osteoporosis: why are we doing so poorly? J Rheumatol 33:1461–1463PubMed
12.
go back to reference Newman ED, Matzko CK, Olenginski TP et al (2006) Glucocorticoid-Induced Osteoporosis Program (GIOP): a novel, comprehensive, and highly successful care program with improved outcomes at 1 year. Osteoporos Int 17:1428–1434PubMedCrossRef Newman ED, Matzko CK, Olenginski TP et al (2006) Glucocorticoid-Induced Osteoporosis Program (GIOP): a novel, comprehensive, and highly successful care program with improved outcomes at 1 year. Osteoporos Int 17:1428–1434PubMedCrossRef
Metadata
Title
Corticosteroid-induced osteoporosis prevention: longitudinal practice patterns in The Netherlands 2001–2005
Authors
M. Duyvendak
M. Naunton
J. Atthobari
P. B. van den Berg
J. R. B. J. Brouwers
Publication date
01-10-2007
Publisher
Springer-Verlag
Published in
Osteoporosis International / Issue 10/2007
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-007-0345-9

Other articles of this Issue 10/2007

Osteoporosis International 10/2007 Go to the issue