KCTBASE

Are glucocorticoid-induced osteoporosis recommendations suffi cient to determine antiosteoporotic treatment for patients with rheumatoid arthritis?

The Korean Journal of Internal Medicine 2014년 29권 4호 p.509 ~ p.515

이주현(Lee Joo-Hyun) - Inje University Ilsan Paik Hospital Department of Internal Medicine
조수경(Cho Soo-Kyung) - Hanyang University Hospital for Rheumatic Diseases Department of Rheumatology
한민경(Han Min-Kyung) - Hanyang University Hospital for Rheumatic Diseases Department of Rheumatology
김담(Kim Dam) - Hanyang University Hospital for Rheumatic Diseases Department of Rheumatology
배상철(Bae Sang-Cheol) - Hanyang University Hospital for Rheumatic Diseases Department of Rheumatology
성윤경(Sung Yoon-Kyoung) - Hanyang University Hospital for Rheumatic Diseases Department of Rheumatology

Abstract

Background/Aims: We investigated diff erences in identifying candidates for antiosteoporotic treatment in rheumatoid arthritis (RA) patients according to two available clinical guidelines.

Methods: We prospectively enrolled 100 female patients aged 50 years or older with RA who visited Hanyang University Hospital for periodic examinations between April 2011 and August 2011. We applied the glucocorticoid-induced osteoporosis (GIOP) recommendations and the National Osteoporosis Foundation (NOF) guidelines to RA patients and examined agreement between the guidelines for identifying candidates for antiosteoporotic treatment. We also analyzed the impact of screening vertebral fractures (VFs) in determining the treatment of osteoporosis in RA patients.

Results: The 57 patients taking glucocorticoids were classifi ed into high-risk (n = 23), medium-risk (n = 16), and low-risk (n = 18) groups according to the GIOP recommendations. Based on the NOF guidelines, 36 of 57 patients were candidates for antiosteoporotic treatment and the agreement between two guidelines was high (κ= 0.76). Two of the 18 patients in the low-risk group and 19 of 43 patients not eligible per the GIOP recommendations were classifi ed as candidates for antiosteoporotic treatment by the NOF guidelines.

Conclusions: In determining antiosteoporotic treatment for RA patients, using only the GIOP recommendations is insuffi cient. Application of the NOF guidelines in patients not eligible for or classifi ed into the low-risk group per the GIOP recommendations and screening for VFs may be helpful in deciding on antiosteoporotic treatment in RA patients.