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ABSTRACT: Glucocorticoid-induced osteoporosis (GIO) is the most frequent cause of secondary osteoporosis. GIO is linked to GC daily assumption with maximum effect within first months of treatment and decreasing to basal levels as the therapy is discontinued. In Italy, primary prevention of GIO is suggested when GC therapy (prednisone >5mg/day or equivalent) is taken for longer than 3 months. Lazio GISMO (Italian Group for Study and Diagnosis of Bone Metabolism Diseases) group organized the GC and Osteoporosis Epidemiology study (EGEO) to evaluate physician's approach in preventing GIO. The study involved 19 osteoporosis centres. Patients taking long-term GC therapy were recruited and information collected: medical history and anthropometric data, GC therapy, primary disease, physician's specialty, osteopororosis screening and pharmacological intervention. 1334 patients were included in the study. Mean age was 63±13 years; 243 (18%) patients had a history of falls from standing position in the previous 12 months, 78 (35%) vertebral fractures, 91 (41%) fractures other than vertebral, 27 (12%) femoral fractures and 27 (12%) multiple sites fractures. The molecules of GC more often prescribed were prednisone and 6-metil prednisolone. 1040 patients (78%) were taking GC longer than 6 months. GC therapy was prescribed more frequently by rheumatologists (62%). Anti-osteoporotic drugs for GIO prevention were prescribed in 431 patients (32%). Only 27% of patients (360) received Calcium and Vitamin D supplements and 39% of patients (319) treated by rheumatologists received antiresorptive drugs. In conclusion our data show that in Italy, as already described elsewhere, only a small subpopulation of GC treated patients was supported by an anti-osteoporotic therapy, indicating the need to further stimulate awareness of both patients and specialists, prescribing GC therapy, to an appropriate and prompt GIO prevention.
Journal of endocrinological investigation 03/2012; · 1.65 Impact Factor