ECTS Abstracts (2015) 1 P363

Medical care of patients at risk of glucocorticoid-induced osteoporosis: the GLUCOST study

Irina Baranova1, Olga Lesnyak2 & on behalf of the GLUCOST Group3


1Pirogov Russian National Research Medical University, Moscow, Russia; 2North-Western State Medical University named after I.I. Mechnikov, Saint Petersburg, Russia; 3GLUCOST Group, Russia.


Background: Osteoporosis prevention and treatment needs to be considered in all patients started on chronic oral glucocorticoids (≧3 months of treatment). The objective was to assess prevention and treatment of glucocorticoid-induced osteoporosis (GIOP) in Russian patients.

Methods: Cross-sectional study was conducted in 34 centers of Russia. 1129 patients (mean age 53,3±13,9, 235 male and 894 female) currently taking long-term oral glucocorticoid therapy due to different chronic inflammatory diseases completed a special questionnaire (including fractures, major risk factors for osteoporosis, knowledge of osteoporosis, BMD testing, prescriptions of specific osteoporosis drugs, calcium and vitamin D supplementation and their actual intake). The median duration of OGC therapy was 5 years, median daily prednisolone dose - 10 mg. The adherence to published national published guidelines for GIOP (updated in 2009) has been evaluated.

Results: 61.8% participants knew about GIOP. Only 48.1% patients underwent BMD testing. Most patients (78.1%) remembered about the importance of obtaining an adequate amount of calcium and vitamin D, but only 43.4% received calcium and vitamin D supplements on a regular basis. 25,4% participants reported osteoporotic fractures. GIOP treatment was assigned to 50.8% of patients at high risk of fractures, but in reality, 40.2% of the patients received it. Diagnosis and treatment of osteoporosis were performed more rarely in men than in women. Participants who knew about osteoporosis were 2.7 times (odds ratio) more likely to take calcium supplements and vitamin D (95% confidence interval [CI] 2.1-3.5, p=0,001) and 3.5 times more likely to comply with treatment (95% CI 2.3-5.3, p=0.001). BMD testing increased the likelihood of anti-osteoporotic drug prescriptions by physicians (8.2[(95% CI 6.2-11.0, ?<0,001]) and the use of drugs by patients (6,5 [95% CI 4,8-8,8, ?<0,001]).

Conclusion: The challenge of the physicians and patients education about the risks of GIOP is not solved.

Disclosure: The authors declared no competing interests.

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