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Abstract Number: 0109

Glucocorticoid-Induced Osteoporosis: Are We Practicing Prevention?

Eileen Rife1, Emejuaiwe Nkechinyere2 and Jose Leon de la Rocha3, 1Louisiana State University, Metairie, LA, 2Department of Veterans Affairs, New Orleans, LA, 3Louisiana State University, Auburn, AL

Meeting: ACR Convergence 2020

Keywords: Dual energy x-ray absorptiometry (DEXA), glucocorticoids, osteoporosis, practice guidelines, prevention

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Session Information

Date: Friday, November 6, 2020

Session Title: Osteoporosis & Metabolic Bone Disease Poster

Session Type: Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose: Descriptive study designed to assess compliance to evidence-based practice guidelines for the prevention of Glucocorticoid-Induced Osteoporosis (GIOP).

Methods: We queried the electronic database of the Department of Veterans Affairs Hospital in New Orleans and collected data on all veterans who filled systemic glucocorticoid (GC) prescriptions during a 2-year study period (January 1, 2016 – December 31, 2017). Data was collected on GC dosage and duration of therapy – with long term GC therapy defined as continuous treatment for ≥3 months (90 days).  Data was also collected on demographics, specialty of the ordering prescriber, bone mineral density (BMD) testing, prescriptions for anti-osteoporotic therapy, and prescriptions for Vitamin D and/or Calcium supplementation. The recommendations followed were in accordance with the American College of Rheumatology, American Geriatrics Society, Institute of Medicine, and National Osteoporosis Foundation guidelines.

Results: During our study period, a total of 1,962 separate GC prescriptions were filled. Of those, 1,051 unique patients were identified. A total of 206 patients were prescribed GC for ≥90 days during the study window and they comprised our study population. Patients were predominately male (97%); 51% self-identified as Caucasian, and 46% as African American. A majority (68%) of prescriptions were for less than 10mg prednisolone-equivalent doses.  Most prescriptions (63% n=130) were for >7.5mg prednisolone-equivalent doses for greater than 90 days.  Primary care providers were the main prescribers of long-term GC (51%, n=105), followed by rheumatologists (24%, n=49). BMD testing was performed in 20% of patients (n=42). Of those tested, 14% (n=6) were found to have osteoporosis and 21% (n=9) had osteopenia. Approximately half of our study population (52%) were prescribed Vitamin D supplementation with 80% prescribed the guideline-recommended dose. Twenty-six percent of patients were prescribed supplemental Calcium, with 44% prescribed the guideline-recommended dose. Fewer than 10% of the patients taking greater than 7.5mg for ≥3 months (and meeting ACR treatment guidelines) were on primary prophylaxis with anti-osteoporotic therapy.

Conclusion: Our findings are overall worsethan previously published data. GIOP remains an under recognized and undertreated condition despite updated evidence-based practice guidelines. Bone mineral density screening rates remain low, as do Calcium/Vitamin D supplementation and primary prophylaxis with anti-osteoporotic therapy.


Disclosure: E. Rife, None; E. Nkechinyere, None; J. Leon de la Rocha, None.

To cite this abstract in AMA style:

Rife E, Nkechinyere E, Leon de la Rocha J. Glucocorticoid-Induced Osteoporosis: Are We Practicing Prevention? [abstract]. Arthritis Rheumatol. 2020; 72 (suppl 10). https://acrabstracts.org/abstract/glucocorticoid-induced-osteoporosis-are-we-practicing-prevention/. Accessed January 15, 2021.
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