Corticosteroid-induced osteoporosis prevention: longitudinal practice patterns in The Netherlands 2001–2005
We investigated prevention trends and predictors for osteoporosis prevention in long term corticosteroid users. The use of bisphosphonates increased from 2001 to 2005. Longer duration of corticosteroid use and DMARD use were predictors for receiving prevention. Females appear reasonably well treated; however, men require more attention.
Previous studies have shown that long-term corticosteroid users are undertreated for osteoporosis prevention. Our aim was to identify prevention trends in long-term corticosteroid users from 2001–2005 in The Netherlands and to identify predictors for bisphosphonate prophylaxis.
Pharmacy dispensing data were used from 9 community pharmacies. All oral corticosteroid doses were converted to “prednisolone equivalents”. We then identified long-term (≥90 days) corticosteroid episodes, which required bisphosphonate prophylaxis as per 2002 Dutch guidelines; Multivariate logistic regression was used to identify predictors for receiving prevention.
We identified 615 different corticosteroid patients requiring prophylaxis. From 2001–2005 the use of bisphosphonates increased from 38% to 54% (p = 0.001). In 2005 females were prescribed more bisphosphonates than males (61% vs. 39%; p = 0.002), or any treatment (72% vs. 45%; p < 0.001). Multivariate analysis showed that longer duration of corticosteroid use and disease-modifying anti-rheumatic drug (DMARD) use were independent predictors of bisphosphonate use. Use of respiratory medication was a negative predictor of bisphosphonate use.
There has been a significant increase in osteoporosis prophylaxis in a population at high risk for osteoporosis/fractures. In particular, females appear reasonably well treated; however, men are still not receiving prevention to the same degree as women.
- Canalis E, Bilezikian JP, Angeli A, Giustina A (2004) Perspectives on glucocorticoid-induced osteoporosis. Bone 34:593–598 CrossRef
- Lukert BP, Raisz LG (1990) Glucocorticoid-induced osteoporosis: pathogenesis and management. Ann Intern Med 112:352–364
- Curtis JR, Westfall AO, Allison JJ et al (2005) Longitudinal patterns in the prevention of osteoporosis in glucocorticoid-treated patients. Arthritis Rheum 52:2485–2494 CrossRef
- Feldstein AC, Elmer PJ, Nichols GA, Herson M (2005) Practice patterns in patients at risk for glucocorticoid-induced osteoporosis. Osteoporos Int 16:2168–2174 CrossRef
- Naunton M, Peterson GM, Jones G, Griffin GM, Bleasel MD (2004) Multifaceted educational program increases prescribing of preventive medication for corticosteroid induced osteoporosis. J Rheumatol 31:550–556
- Osteoporose Tweede Herziene Richtlijn [Osteoporosis, Second Revised Guideline] (2002) ISBN 90-76906-23-8, 2nd ed. Utrecht: Van Zuiden Communications B.V.
- World Health Organization. The WHO Collaborating Centre for Drug Statistics Methodology: http://www.whocc.no/atcddd/ (accessed February 2006)
- Saag KG, Gehlbach SH, Curtis JR, Youket TE, Worley K, Lange JL (2006) Trends in prevention of glucocorticoid-induced osteoporosis. J Rheumatol 33:1651–1657
- van Staa TP, Leufkens HG, Abenhaim L, Begaud B, Zhang B, Cooper C (2000) Use of oral corticosteroids in the United Kingdom. QJM 93:105–111 CrossRef
- Walsh LJ, Wong CA, Pringle M, Tattersfield AE (1996) Use of oral corticosteroids in the community and the prevention of secondary osteoporosis: a cross sectional study. BMJ 313:344–346
- Yood RA (2006) Prevention of glucocorticoid-induced osteoporosis: why are we doing so poorly? J Rheumatol 33:1461–1463
- Newman ED, Matzko CK, Olenginski TP et al (2006) Glucocorticoid-Induced Osteoporosis Program (GIOP): a novel, comprehensive, and highly successful care program with improved outcomes at 1 year. Osteoporos Int 17:1428–1434 CrossRef
- Corticosteroid-induced osteoporosis prevention: longitudinal practice patterns in The Netherlands 2001–2005
- Open Access
- Available under Open Access This content is freely available online to anyone, anywhere at any time.
Volume 18, Issue 10 , pp 1429-1433
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Prescribing patterns
- The Netherlands
- Industry Sectors
- Author Affiliations
- 1. Department of Clinical Pharmacy, Tjongerschans Hospital, Heerenveen, The Netherlands
- 2. Department of Pharmacotherapy and Pharmaceutical Care, University of Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands
- 3. School of Science, Charles Darwin University, Northern Territory, Australia
- 4. Groningen University Institute for Drug Exploration (GUIDE), Groningen, The Netherlands