High-dose corticosteroid exposure and osteoporosis intervention in adults
التاريخ:
2006-11-29
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<font >Background: High-dose corticosteroid exposure is associated with increased risk of bone loss and osteoporotic fractures.</font>
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<p><font size="3"><font >Objective: To examine high-dose corticosteroid use and osteoporosis screening and treatment trends in patients receiving high-dose oral or inhaled corticosteroids in a large managed care organization.</font></font></p>
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<p><font size="3"><font >Methods: We reviewed electronic records of inhaled and oral corticosteroid use and osteoporosis intervention in 2002 among patients 20 years or older and developed algorithms to quantitate high cumulative exposure to corticosteroids.</font></font></p>
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<p><font size="3"><font >Results: High-dose exposure to corticosteroids was found in 18,737 health plan members (0.8%) (7,757 men [41%] and 10,980 women [59%]). Prevalence increased with age, from 0.4% (age range, 20-49 years) to 1% (age range, 50-64 years) and 2% (age range, ≥75 years). Of high-dose users, 72% used only oral, 15% used only inhaled, and 13% used combined oral and inhaled corticosteroids. Bone densitometry was performed in 9% of men and 27% of women exposed to oral corticosteroids and in 4% of men and 23% of women exposed to inhaled corticosteroids. Prescriptions for osteoporosis drugs were filled by 6% of men and 11% of women receiving oral corticosteroids and by 1% of men and 5% of women receiving inhaled corticosteroids.</font></font></p>
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<p><font size="3"><font >Conclusion: Approximately 1 in 125 people 20 years or older were exposed to high doses of corticosteroids; oral exposure was 3 times more common than inhaled exposure. Most exposed patients do not receive bone density testing or osteoporosis drug prophylaxis. Use of prescription databases to identify high-dose oral and inhaled corticosteroid users can enable focused intervention to reduce bone loss and potentially reduce the risk of osteoporotic fractures.</font></font></p>
<p dir="ltr"><font size="3"><font >Source: Annals of Allergy, Asthma & Immunology. 2006, vol. 97, no. 4, pp. 497 - 501</font></font></p>
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