High level of adherence to osteoporosis prophylaxis medications in steroid-treated polymyalgia rheumatica (pmr)/giant cell arteritis (gca) patients

A prospective cohort study

Research output: Contribution to conference without publisher/journalPosterResearchpeer-review

Abstract

Objectives: Adherence to the osteoporosis prophylaxis medications can play a significant role to prevent steroid-induced osteoporosis. The objective of this study was to evaluate the level of adherence to osteoporosis prophylaxis medications in newly diagnosed steroid-treated polymyalgia rheumatica (PMR)/giant cell arteritis (GCA) patients. Method: This is an ongoing prospective study. 37 consecutive pts. with newly diagnosed PMR/GCA were included in the study. The patients were requested to perform a total body DXA at time of diagnosis or shortly after. Hereafter, patients were contacted by nurses after a week of treatment initiation to evaluate the effect of treatment and to review the details. After 4 weeks of treatment with prednisolone, all included patients were interviewed about their compliance towards osteoporosis prophylaxis using a standardized questionnaire at first follow up visit. Patients were asked if they had remembered to take their prescribed medications. The standard treatment for prevention of osteoporosis was calcium (1200 mg/d) plus vitamin D (800 U/d) and 70 mg alendronate weekly (if T-score ≤−1). Results: Of 37 pts., 3 pts. were excluded from the study because of lack of interest or a change in the initial diagnosis. Statistical analyses were performed for the rest 34 pts. Results of DXA scan were available for 30 pts. Of all included pts. 61.8% were female and mean age (confidence interval) was 71 (69-74) y. 24 pts. had pure PMR symptoms, 2 pts. pure cranial GCA, 8 pts. with concurrent PMR and GCA. The cumulative prednisolone dose was 696.2 (516.9-1123.1) (median (interquartile range)). The mean of erythrocyte sedimentation rate 61.8 and C-reactive protein 44.9 at diagnosis decreased to 10.7 and 4.0, respectively, after 4 weeks of treatment. At time of diagnosis, 30% and 53.3% of pts. had osteoporosis (T-score ≤ -2.5) and osteopenia (-1≤ T-score <-2.5), respectively. Of included patients, 92.6% were (100%) and 7.4% were (50-100%) adherent to their prescribed medications [Figure1]. Forgetfulness was mentioned as the most important reason for the decreased adherence. Conclusion: Though previous research was in favor of low level of adherence to osteoporosis prophylaxis drugs, we found a high level of adherence in this specific group of patients at first follow up visit. These findings are in line with our earlier results that showed a high level of adherence in PMR/GCA patients [1,2]. References: 1. Emamifar A, Gildberg-Mortensen R, Andreas Just S, et al. Int J Rheumatol 2015;2015:783709. 2. Jakobsen S, Emamifar A, Hansen I. Ann Rheumatic Dis 2016;75:1302. Acknowledgement: Study data were collected and managed using REDCap electronic data capture tools hosted at University of Southern Denmark. Disclosure: The present study is funded by the Region of Southern Denmark, The Danish Rheumatism Association, Department of Rheumatology Svendborg Hospital, Department of Medicine Svendborg Hospital, University of Southern Denmark and Odense University Hospital.
Original languageEnglish
Publication date2018
Publication statusPublished - 2018
Event7th Asia-Pacific Osteoporosis Conference - International Convention Centre Sydney, Sydney, Australia
Duration: 28. Nov 20181. Dec 2018

Conference

Conference7th Asia-Pacific Osteoporosis Conference
LocationInternational Convention Centre Sydney
CountryAustralia
CitySydney
Period28/11/201801/12/2018

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Polymyalgia Rheumatica
Cohort Studies
Prospective Studies
Denmark
Hospital Medicine
Alendronate
Hospital Departments
Photon Absorptiometry
Rheumatology
Rheumatic Diseases
Compliance
Nurses
Confidence Intervals

Cite this

@conference{f8f89cb061ec462a99875c6dbe9bb4a9,
title = "High level of adherence to osteoporosis prophylaxis medications in steroid-treated polymyalgia rheumatica (pmr)/giant cell arteritis (gca) patients: A prospective cohort study",
abstract = "Objectives: Adherence to the osteoporosis prophylaxis medications can play a significant role to prevent steroid-induced osteoporosis. The objective of this study was to evaluate the level of adherence to osteoporosis prophylaxis medications in newly diagnosed steroid-treated polymyalgia rheumatica (PMR)/giant cell arteritis (GCA) patients. Method: This is an ongoing prospective study. 37 consecutive pts. with newly diagnosed PMR/GCA were included in the study. The patients were requested to perform a total body DXA at time of diagnosis or shortly after. Hereafter, patients were contacted by nurses after a week of treatment initiation to evaluate the effect of treatment and to review the details. After 4 weeks of treatment with prednisolone, all included patients were interviewed about their compliance towards osteoporosis prophylaxis using a standardized questionnaire at first follow up visit. Patients were asked if they had remembered to take their prescribed medications. The standard treatment for prevention of osteoporosis was calcium (1200 mg/d) plus vitamin D (800 U/d) and 70 mg alendronate weekly (if T-score ≤−1). Results: Of 37 pts., 3 pts. were excluded from the study because of lack of interest or a change in the initial diagnosis. Statistical analyses were performed for the rest 34 pts. Results of DXA scan were available for 30 pts. Of all included pts. 61.8{\%} were female and mean age (confidence interval) was 71 (69-74) y. 24 pts. had pure PMR symptoms, 2 pts. pure cranial GCA, 8 pts. with concurrent PMR and GCA. The cumulative prednisolone dose was 696.2 (516.9-1123.1) (median (interquartile range)). The mean of erythrocyte sedimentation rate 61.8 and C-reactive protein 44.9 at diagnosis decreased to 10.7 and 4.0, respectively, after 4 weeks of treatment. At time of diagnosis, 30{\%} and 53.3{\%} of pts. had osteoporosis (T-score ≤ -2.5) and osteopenia (-1≤ T-score <-2.5), respectively. Of included patients, 92.6{\%} were (100{\%}) and 7.4{\%} were (50-100{\%}) adherent to their prescribed medications [Figure1]. Forgetfulness was mentioned as the most important reason for the decreased adherence. Conclusion: Though previous research was in favor of low level of adherence to osteoporosis prophylaxis drugs, we found a high level of adherence in this specific group of patients at first follow up visit. These findings are in line with our earlier results that showed a high level of adherence in PMR/GCA patients [1,2]. References: 1. Emamifar A, Gildberg-Mortensen R, Andreas Just S, et al. Int J Rheumatol 2015;2015:783709. 2. Jakobsen S, Emamifar A, Hansen I. Ann Rheumatic Dis 2016;75:1302. Acknowledgement: Study data were collected and managed using REDCap electronic data capture tools hosted at University of Southern Denmark. Disclosure: The present study is funded by the Region of Southern Denmark, The Danish Rheumatism Association, Department of Rheumatology Svendborg Hospital, Department of Medicine Svendborg Hospital, University of Southern Denmark and Odense University Hospital.",
author = "Amir Emamifar and Ellingsen, {Torkell Juulsgaard} and Hermann, {Anne Pernille} and S{\o}ren Hess and {Jensen Hansen}, {Inger Marie} and Peter Thye-R{\o}nn",
year = "2018",
language = "English",
note = "7th Asia-Pacific Osteoporosis Conference ; Conference date: 28-11-2018 Through 01-12-2018",

}

High level of adherence to osteoporosis prophylaxis medications in steroid-treated polymyalgia rheumatica (pmr)/giant cell arteritis (gca) patients : A prospective cohort study. / Emamifar, Amir; Ellingsen, Torkell Juulsgaard; Hermann, Anne Pernille; Hess, Søren; Jensen Hansen, Inger Marie; Thye-Rønn, Peter.

2018. Poster session presented at 7th Asia-Pacific Osteoporosis Conference, Sydney, Australia.

Research output: Contribution to conference without publisher/journalPosterResearchpeer-review

TY - CONF

T1 - High level of adherence to osteoporosis prophylaxis medications in steroid-treated polymyalgia rheumatica (pmr)/giant cell arteritis (gca) patients

T2 - A prospective cohort study

AU - Emamifar, Amir

AU - Ellingsen, Torkell Juulsgaard

AU - Hermann, Anne Pernille

AU - Hess, Søren

AU - Jensen Hansen, Inger Marie

AU - Thye-Rønn, Peter

PY - 2018

Y1 - 2018

N2 - Objectives: Adherence to the osteoporosis prophylaxis medications can play a significant role to prevent steroid-induced osteoporosis. The objective of this study was to evaluate the level of adherence to osteoporosis prophylaxis medications in newly diagnosed steroid-treated polymyalgia rheumatica (PMR)/giant cell arteritis (GCA) patients. Method: This is an ongoing prospective study. 37 consecutive pts. with newly diagnosed PMR/GCA were included in the study. The patients were requested to perform a total body DXA at time of diagnosis or shortly after. Hereafter, patients were contacted by nurses after a week of treatment initiation to evaluate the effect of treatment and to review the details. After 4 weeks of treatment with prednisolone, all included patients were interviewed about their compliance towards osteoporosis prophylaxis using a standardized questionnaire at first follow up visit. Patients were asked if they had remembered to take their prescribed medications. The standard treatment for prevention of osteoporosis was calcium (1200 mg/d) plus vitamin D (800 U/d) and 70 mg alendronate weekly (if T-score ≤−1). Results: Of 37 pts., 3 pts. were excluded from the study because of lack of interest or a change in the initial diagnosis. Statistical analyses were performed for the rest 34 pts. Results of DXA scan were available for 30 pts. Of all included pts. 61.8% were female and mean age (confidence interval) was 71 (69-74) y. 24 pts. had pure PMR symptoms, 2 pts. pure cranial GCA, 8 pts. with concurrent PMR and GCA. The cumulative prednisolone dose was 696.2 (516.9-1123.1) (median (interquartile range)). The mean of erythrocyte sedimentation rate 61.8 and C-reactive protein 44.9 at diagnosis decreased to 10.7 and 4.0, respectively, after 4 weeks of treatment. At time of diagnosis, 30% and 53.3% of pts. had osteoporosis (T-score ≤ -2.5) and osteopenia (-1≤ T-score <-2.5), respectively. Of included patients, 92.6% were (100%) and 7.4% were (50-100%) adherent to their prescribed medications [Figure1]. Forgetfulness was mentioned as the most important reason for the decreased adherence. Conclusion: Though previous research was in favor of low level of adherence to osteoporosis prophylaxis drugs, we found a high level of adherence in this specific group of patients at first follow up visit. These findings are in line with our earlier results that showed a high level of adherence in PMR/GCA patients [1,2]. References: 1. Emamifar A, Gildberg-Mortensen R, Andreas Just S, et al. Int J Rheumatol 2015;2015:783709. 2. Jakobsen S, Emamifar A, Hansen I. Ann Rheumatic Dis 2016;75:1302. Acknowledgement: Study data were collected and managed using REDCap electronic data capture tools hosted at University of Southern Denmark. Disclosure: The present study is funded by the Region of Southern Denmark, The Danish Rheumatism Association, Department of Rheumatology Svendborg Hospital, Department of Medicine Svendborg Hospital, University of Southern Denmark and Odense University Hospital.

AB - Objectives: Adherence to the osteoporosis prophylaxis medications can play a significant role to prevent steroid-induced osteoporosis. The objective of this study was to evaluate the level of adherence to osteoporosis prophylaxis medications in newly diagnosed steroid-treated polymyalgia rheumatica (PMR)/giant cell arteritis (GCA) patients. Method: This is an ongoing prospective study. 37 consecutive pts. with newly diagnosed PMR/GCA were included in the study. The patients were requested to perform a total body DXA at time of diagnosis or shortly after. Hereafter, patients were contacted by nurses after a week of treatment initiation to evaluate the effect of treatment and to review the details. After 4 weeks of treatment with prednisolone, all included patients were interviewed about their compliance towards osteoporosis prophylaxis using a standardized questionnaire at first follow up visit. Patients were asked if they had remembered to take their prescribed medications. The standard treatment for prevention of osteoporosis was calcium (1200 mg/d) plus vitamin D (800 U/d) and 70 mg alendronate weekly (if T-score ≤−1). Results: Of 37 pts., 3 pts. were excluded from the study because of lack of interest or a change in the initial diagnosis. Statistical analyses were performed for the rest 34 pts. Results of DXA scan were available for 30 pts. Of all included pts. 61.8% were female and mean age (confidence interval) was 71 (69-74) y. 24 pts. had pure PMR symptoms, 2 pts. pure cranial GCA, 8 pts. with concurrent PMR and GCA. The cumulative prednisolone dose was 696.2 (516.9-1123.1) (median (interquartile range)). The mean of erythrocyte sedimentation rate 61.8 and C-reactive protein 44.9 at diagnosis decreased to 10.7 and 4.0, respectively, after 4 weeks of treatment. At time of diagnosis, 30% and 53.3% of pts. had osteoporosis (T-score ≤ -2.5) and osteopenia (-1≤ T-score <-2.5), respectively. Of included patients, 92.6% were (100%) and 7.4% were (50-100%) adherent to their prescribed medications [Figure1]. Forgetfulness was mentioned as the most important reason for the decreased adherence. Conclusion: Though previous research was in favor of low level of adherence to osteoporosis prophylaxis drugs, we found a high level of adherence in this specific group of patients at first follow up visit. These findings are in line with our earlier results that showed a high level of adherence in PMR/GCA patients [1,2]. References: 1. Emamifar A, Gildberg-Mortensen R, Andreas Just S, et al. Int J Rheumatol 2015;2015:783709. 2. Jakobsen S, Emamifar A, Hansen I. Ann Rheumatic Dis 2016;75:1302. Acknowledgement: Study data were collected and managed using REDCap electronic data capture tools hosted at University of Southern Denmark. Disclosure: The present study is funded by the Region of Southern Denmark, The Danish Rheumatism Association, Department of Rheumatology Svendborg Hospital, Department of Medicine Svendborg Hospital, University of Southern Denmark and Odense University Hospital.

M3 - Poster

ER -