Abstract
Objective To assess whether the 2003 and 2014 French guidelines on the prevention and treatment of glucocorticoid-induced osteoporosis (GIOP) and the 2012 updated of French guidelines for the treatment of postmenopausal osteoporosis (PMOP) were applied in patients with rheumatoid arthritis (RA).
Methods We conducted a cross-sectionnal study of 776 RA patients (19 centers). We collected the data required for the application of the various recommendations (age, gender, 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 anti-osteoporosis treatment, those who were actually treated represented 22.6% (according to the 2014 guidelines), 27.3% (according to the 2003 guidelines) and 23.6% of postmenopausal women (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). On 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 minutes a day according to the 2003 guidelines, and with older age, lower body mass index, and a T-score ≤ -2.5 in at least one 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.