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Current management of corticosteroid-induced osteoporosis: Variations in awareness and management

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Abstract

Background Guidelines for the prevention of corticosteroid-induced osteoporosis (CIO) have been widely published. There are no guidelines on the use of gastro-protectants with corticosteroids (CS).

Aims To determine whether patients receiving CS therapy are evaluated and treated for osteoporosis risk, how management varied by steroid dose and diagnosis, and how many patients received gastro-protection.

Methods A retrospective audit of 4,350 patients presenting to four medical specialities.

Results One hundred and fifty-one patients prescribed CS were identified. Indications for CS therapy included renal transplantation (32%) and asthma/respiratory diseases (23%), inflammatory arthritis/vasculitis (32%) and inflammatory bowel disease/auto-immune hepatitis/other (13%). Risk of osteoporosis was mentioned in 13% of charts. The prescription rates for bone protection agents varied from 69% to 4% according to the medical speciality attended. Gastro-protectants were prescribed for 44% of patients.

Conclusion There are large variations among medical specialties both in the prescription of gastro-protectant agents and in the use of measures to prevent CIO. Simpler guidelines could facilitate rational prescribing in these patients.

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Authors and Affiliations

  1. Departments of Rheumatology, Beaumont Hospital and Royal College of Surgeons in Ireland, Dublin, Ireland

    JG Ryan & PG O’Connell

  2. Respiratory Medicine, Beaumont Hospital and Royal College of Surgeons in Ireland, Dublin, Ireland

    RK Morgan

  3. Nephrology, Beaumont Hospital and Royal College of Surgeons in Ireland, Dublin, Ireland

    PJ Lavin

  4. Nephrology and Gastroenterology/Clinical Pharmacology, Beaumont Hospital and Royal College of Surgeons in Ireland, Dublin, Ireland

    FE Murray

Authors
  1. JG Ryan
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  2. RK Morgan
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  3. PJ Lavin
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  4. FE Murray
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  5. PG O’Connell
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Correspondence to PG O’Connell.

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Ryan, J., Morgan, R., Lavin, P. et al. Current management of corticosteroid-induced osteoporosis: Variations in awareness and management. Ir J Med Sci 173, 20–22 (2004). https://doi.org/10.1007/BF02914518

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