Most guidelines recommend that preventive measures for GIOP, including BMD tests, calcium and/or vitamin D supplementation, and osteoporosis medications, should be commenced within 6 months of GC initiation if daily doses of 2.5 mg to 7.5 mg or more of prednisolone-equivalent GC have to be taken continuously for 3 months or more. Numerous academic societies and national-level specialty groups, such as the American College of Rheumatology, the Japanese Society for Bone and Mineral Research, the Korean Society for Bone and Mineral Research, the Korean College of Rheumatology (KSBMR/KCR), the French Society for Rheumatology and Osteoporosis Research and Information Group, the International Osteoporosis Foundation, and the European Calcified Tissue Society, have released guidelines for the management of GIOP. Thus, GC should be administered at the lowest dose for the shortest period of time, and if long-term glucocorticoid treatment is inevitable, special attention is required to prevent fractures. Fractures can occur even with low daily dose exposure of long-term GC and are independent of bone mineral density (BMD) and age. Bone loss occurs rapidly within the first 3 to 6 months of GC initiation and persists at a slower rate thereafter thus, the risk of fracture peaks at 12 months. Although GC can affect both trabecular and cortical bones, fragility fractures occur more commonly in the trabecular bone, such as the lumbar vertebrae. GIOP develops in approximately 30–50% of patients receiving long-term GC therapy, and the risk of fracture increases by more than 50% in these patients, which imposes a significant clinical burden due to increased morbidity and mortality. However, long-term use of GC can cause a myriad of adverse effects, among which the most serious one is the reduction of bone density and derangement of bone quality, leading to glucocorticoid-induced osteoporosis (GIOP), the most common form of secondary osteoporosis. ![]() More efforts are needed by clinicians to prevent, screen, and treat GIOP.Īpproximately 1% of the adult population worldwide are treated with long-term systemic glucocorticoids (GC), which are widely used for the management of a variety of disorders due to their anti-inflammatory and immunosuppressive properties these disorders include systemic autoimmune diseases, inflammatory bowel diseases, chronic pulmonary diseases, allergic diseases, hematologic malignancy, and following organ transplants. Conclusions: Most Korean patients treated with GC did not receive appropriate preventive care for GIOP in real-world practice. ![]() Male sex (OR = 0.26, p < 0.001) and GC prescription in primary care clinics and nursing hospitals (OR = 0.66, p < 0.001) were associated with a lower rate of high-quality GIOP preventive care. Increasing age (OR = 2.53, p < 0.001 40–49 years, OR = 3.99, p < 0.001 50–59 years, OR = 5.17, p < 0.001 60–69 years, OR = 8.07, p < 0.001 ≥70 years, respectively), systemic autoimmune disease (OR = 3.08, p < 0.001), rural residence (OR = 1.19, p = 0.046), concomitant hyperthyroidism (OR = 1.58, p = 0.007), and malignancy (OR = 1.59, p < 0.001) were significantly associated with a higher likelihood of receiving high-quality GIOP preventive care. The frequency of high-quality GIOP preventive care was only 3.68% (BMD test, 1.46% osteoporosis medications, 1.65% calcium/vitamin D, 1.63%). Results: The mean age was 49.8 years, and 18,476 (49.8%) patients were female. Multivariable logistic regression models were used to calculate odds ratios (ORs) for associated factors for high-quality GIOP preventive care. ![]() High-quality GIOP preventive care was defined as either a bone mineral density (BMD) test, calcium and/or vitamin D supplementation, or prescription osteoporosis medications within 6 months of GC initiation. Materials and Methods: Using the Korean National Health Insurance Service database, we identified 37,133 individuals aged ≥ 20 years who commenced long-term (≥90 days) oral GC between 20. This study aimed to investigate the frequency and associated factors of preventive care for glucocorticoid-induced osteoporosis (GIOP) in Korea. ![]() Background and Objectives: It is crucial to prevent osteoporosis in patients receiving long-term glucocorticoid (GC) treatment.
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