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.
|Publication status||Published - 2018|
|Event||7th Asia-Pacific Osteoporosis Conference - International Convention Centre Sydney, Sydney, Australia|
Duration: 28. Nov 2018 → 1. Dec 2018
|Conference||7th Asia-Pacific Osteoporosis Conference|
|Location||International Convention Centre Sydney|
|Period||28/11/2018 → 01/12/2018|