Sandrine Malochet-Guinamand1,2, Céline Lambert3,4, Laure Gossec3,4, Martin Soubrier3,4, Maxime Dougados3,4. 1. From the Rheumatology Department, and Biostatistics Unit (DRCI), University Hospital Clermont-Ferrand, Auvergne; Sorbonne University; Pitié Salpêtrière Hospital, AP-HP, Rheumatology Department; Rheumatology Department, Cochin Hospital, AP-HP, Paris Descartes University; Clinical Epidemiology and Biostatistics, INSERM (U1153), PRES Sorbonne Paris-Cité, Paris, France. smalochet@chu-clermontferrand.fr. 2. S. Malochet-Guinamand, MD, University Hospital Clermont-Ferrand, Rheumatology Department; C. Lambert, MSc, University Hospital Clermont-Ferrand, Biostatistics Unit (DRCI); L. Gossec, PhD, Sorbonne University, and Pitié Salpêtrière Hospital, AP-HP, Rheumatology Department; M. Soubrier, PhD, University Hospital Clermont-Ferrand, Rheumatology Department; M. Dougados, PhD, Rheumatology Department, Cochin Hospital, AP-HP, Paris Descartes University, and Clinical Epidemiology and Biostatistics, INSERM (U1153), PRES Sorbonne Paris-Cité. smalochet@chu-clermontferrand.fr. 3. From the Rheumatology Department, and Biostatistics Unit (DRCI), University Hospital Clermont-Ferrand, Auvergne; Sorbonne University; Pitié Salpêtrière Hospital, AP-HP, Rheumatology Department; Rheumatology Department, Cochin Hospital, AP-HP, Paris Descartes University; Clinical Epidemiology and Biostatistics, INSERM (U1153), PRES Sorbonne Paris-Cité, Paris, France. 4. S. Malochet-Guinamand, MD, University Hospital Clermont-Ferrand, Rheumatology Department; C. Lambert, MSc, University Hospital Clermont-Ferrand, Biostatistics Unit (DRCI); L. Gossec, PhD, Sorbonne University, and Pitié Salpêtrière Hospital, AP-HP, Rheumatology Department; M. Soubrier, PhD, University Hospital Clermont-Ferrand, Rheumatology Department; M. Dougados, PhD, Rheumatology Department, Cochin Hospital, AP-HP, Paris Descartes University, and Clinical Epidemiology and Biostatistics, INSERM (U1153), PRES Sorbonne Paris-Cité.
Abstract
OBJECTIVE: To assess whether the 2003 and 2014 French guidelines on the prevention and treatment of glucocorticoid-induced osteoporosis (GIOP) and the 2012 update of the French guidelines for the treatment of postmenopausal osteoporosis (PMOP) were applied in patients with rheumatoid arthritis (RA). METHODS: We conducted a cross-sectional study of 776 patients with RA (19 centers). We collected the data required for the application of the various recommendations (age, sex, prednisone intake, low-energy fracture, history in the immediate family of hip fractures, and bone densitometry), anti-osteoporotic drugs, and the various factors that may be associated with the application of the recommendations. RESULTS: Of the patients who should have received antiosteoporosis treatment, there were 22.6% actually treated (according to the 2014 guidelines), 27.3% actually treated according to the 2003 guidelines, and of postmenopausal women, 23.6% (according to the 2012 PMOP guidelines). Applying the 2014 GIOP guidelines increased the theoretical number of patients requiring treatment relative to the 2003 GIOP guidelines (77% vs 53%; p < 0.001). In multivariate analysis, being treated was associated with a spinal T score ≤ -2 SD according to the 2014 guidelines; with not taking part in physical activity for more than 30 min a day according to the 2003 guidelines; and with older age, lower body mass index, and a T score ≤ -2.5 SD in at least 1 site according to the PMOP guidelines. CONCLUSION: Patients with RA had inadequate prevention of GIOP and PMOP. The management of osteoporosis needs to be improved in this population.
OBJECTIVE: To assess whether the 2003 and 2014 French guidelines on the prevention and treatment of glucocorticoid-induced osteoporosis (GIOP) and the 2012 update of the French guidelines for the treatment of postmenopausal osteoporosis (PMOP) were applied in patients with rheumatoid arthritis (RA). METHODS: We conducted a cross-sectional study of 776 patients with RA (19 centers). We collected the data required for the application of the various recommendations (age, sex, prednisone intake, low-energy fracture, history in the immediate family of hip fractures, and bone densitometry), anti-osteoporotic drugs, and the various factors that may be associated with the application of the recommendations. RESULTS: Of the patients who should have received antiosteoporosis treatment, there were 22.6% actually treated (according to the 2014 guidelines), 27.3% actually treated according to the 2003 guidelines, and of postmenopausal women, 23.6% (according to the 2012 PMOP guidelines). Applying the 2014 GIOP guidelines increased the theoretical number of patients requiring treatment relative to the 2003 GIOP guidelines (77% vs 53%; p < 0.001). In multivariate analysis, being treated was associated with a spinal T score ≤ -2 SD according to the 2014 guidelines; with not taking part in physical activity for more than 30 min a day according to the 2003 guidelines; and with older age, lower body mass index, and a T score ≤ -2.5 SD in at least 1 site according to the PMOP guidelines. CONCLUSION:Patients with RA had inadequate prevention of GIOP and PMOP. The management of osteoporosis needs to be improved in this population.
Entities:
Keywords:
OSTEOPOROSIS; PRACTICE GUIDELINES; RHEUMATOID ARTHRITIS