Prevention, diagnosis, and treatment of glucocorticoid induced osteoporosis by rheumatologists in a Latin-American city

Objectives: To examine current practices for the diagnosis and therapy for glucocorticoid-induced osteoporosis (GIOP) in patients under treatment with corticosteroids at outpatient clinics of rheumatologists in a Colombian Caribbean city. Methods: All patients noted to be using of glucocorticoids (GC) on an index consult from February to May 2004 were included in a descriptive cross sectional study. Criteria for inclusion of patients were to have had, at least, one previous visit to the service. We evaluated the study population for osteoporosis diagnosis, procedures, and treatment. Results: Of the 121 patients included, 103 (85.1%) were female and 18 (14.9%) were male; 76 patients (62.8%) were under 50 years, and 45 (37.2%) were over 50 years. Main reasons for corticosteroid use were rheumatoid arthritis in 68 patients (56.2%) and systemic lupus erythematous (SLE) in 31 patients (25.6%). Diagnostic testing for osteoporosis was reported on 50.1% of patients. Peripheral dual energy x-ray absorptiometry was the most frequently used method (52.6%). Therapeutic agents for GIOP were used in 96 patients (79.3%), with Calcium plus Vitamin D (55.2%) the principal treatments prescribed. Conclusions: We found similar rates of diagnosis and treatment for GIOP to those reported in North America and Europe, although in this study treatment was mainly with calcium and vitamin D. There was a statistically significant relationship between being studied with any diagnostic method and being treated for GIOP. There may be undertreatment for GIOP in Latin America. Local interventions to improve care for patients in chronic use of steroids are needed.