Few patients on steroids receive bone-saving drugs
Contrary to the guidelines of the American College of Rheumatology (ACR), patients on long-term steroid treatment are often not prescribed therapy to prevent the bone-thinning disease osteoporosis, according to findings from a small study.
Steroids are commonly prescribed for chronic skin diseases and “autoimmune” conditions in which the body attacks itself. “Patients receiving long-term corticosteroid therapy have an increased risk of developing osteoporosis,” said Dr. Victoria P. Werth of the Veterans Administration Hospital in Philadelphia.
“In the last 10 years, the literature has produced very good guidelines for how to try to prevent osteoporosis, but I’m aware of the fact that in any community, not just dermatology, the guidelines are not being followed very carefully,” Werth said. The ACR guidelines recommend so-called bisphosphonate drugs (Fosamax is an example) for all patients beginning long-term steroid treatment.
Werth and her colleagues studied 35 patients with chronic skin disease who were taking the steroid prednisone for at least a month. The researchers evaluated the use of bisphosphonates through medical chart reviews and communication with the patients.
As they report in the Archives of Dermatology, the researchers found that 28 of the 35 patients were not receiving bisphosphonates and the proportion of patients on preventive treatment didn’t change after the ACR guidelines were published.
“Many papers show that bisphosphonates maintain or even increase bone (thickness) and that they decrease the number of fractures,” Werth said. “Bisphosphonates work. This study was really an effort to increase awareness among dermatologists that they need to follow the guidelines.”
SOURCE: Archives of Dermatology, January 2006.
Tell-a-Friend comments powered by Disqus