Background/Purpose: Non-pharmacologic treatments are generally kept in the background in management of osteoporosis. The aim of this retrospective study was to evaluate characteristics and frequency of pharmacologic and non-pharmacologic treatments for patients with osteoporosis (OP), in a university hospital, outpatient clinic of Physical Medicine and Rehabilitation, during the last 6 months.

Methods: A hundred and fifty-five OP patients, who were not having any malignancy and/or terminal-term chronic disease, were included to this study. Demographic properties (age, gender, disease duration), clinical characteristics (fracture history, comorbidities, drugs) and treatment approaches for OP (pharmacologic and non-pharmacological) were recorded from files. Descriptive statistics were used for clinical variables and frequency of treatment approaches.

Results: 137 female, 18 male OP patients with a mean age of 66.11± 11.21 years, were included to the study. Post-menopausal osteoporosis was present in 130 (83.8%) and secondary OP was determined in 25 (16.2%) of the subjects. The mean duration of OP was 6.95±1.11 years. 24.5% of the patients had at least one porotic fracture. The most frequently causes of secondary OP were drugs (mostly steroids) and comorbid diseases (endocrine diseases, asthma, rheumatic conditions). Pharmacological treatments were prevalent and the most commonly prescribed drugs were denosumab (35.7%), alendronate (22.4%) and ibandronate (10.5%) followed by zolendronic acid (7.7%), teriparatide (2.8%) and risedronate (2.7%). Majority of the patients (68.1%) were concurrently on calcium and/or Vit D therapies. Non-pharmacologic treatments were suggested in 60% of the patients, mostly as exercise (50%), diet (37.5%), lifestyle modifications (28.6%); but only 50% of the subjects were performing regular exercises.

Conclusion: Pharmacologic approaches were common and mostly denosumab and biphosphonates were the first choices for OP treatment in our study group. Although non-pharmacologic approaches are of great value in OP management (1,2), approximately only half of our patients were prescribed these interventions in our study. We believe that there is an unmet need for non-pharmacologic management in OP. We suggest and emphasize the concurrent recommendations of non-pharmacologic interventions in OP patients, especially in rehabilitation clinics.

References

1. Christianson MS, Shen W. Osteoporosis prevention and management: nonpharmacologic and lifestyle options. Clin Obstet Gynecol. 2013 Dec;56(4):703-10
2. Kasturi GC, Adler RA. Osteoporosis: nonpharmacologic management. PM R. 2011 Jun;3(6):562-72.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/pharmacological-and-non-pharmacological-approaches-in-a-group-of-osteoporotic-patients-referring-to-a-rehabilitation-out-patient-clinic/