Epidemiology of glucocorticoid-induced osteoporosis and management of associated fracture risk in Japan.
Identifieur interne : 000048 ( Main/Exploration ); précédent : 000047; suivant : 000049Epidemiology of glucocorticoid-induced osteoporosis and management of associated fracture risk in Japan.
Auteurs : Satoshi Soen [Japon] ; Miki Kaku [Japon] ; Naoki Okubo [Japon] ; Salsabil Touzeni [Tunisie] ; Kengo Saito [Japon] ; Makiko Kobayashi [Japon]Source :
- Journal of bone and mineral metabolism [ 1435-5604 ] ; 2021.
Abstract
INTRODUCTION
Glucocorticoid-induced osteoporosis (GIOP) is associated with a high fracture risk. Practice guidelines by the Japanese Society for Bone and Mineral Research in 2014 recommend bone densitometry and appropriate treatment to reduce this risk. The study objectives were to describe characteristics of GIOP patients in Japan and to evaluate their management in a subgroup of patients without comorbid cancer.
MATERIALS AND METHODS
This retrospective cohort study was performed using the Medical Data Vision (MDV) database from Japan. Adult patients initiating oral glucocorticoid treatment with a total GIOP risk score ≥ 3, based on the 2014 practice guideline, identified between 2009 and 2019 were eligible. A subgroup of patients without any cancer diagnosis was also identified. Data were extracted on demographics, concurrent medical conditions, use of bone densitometry, and osteoporosis treatment.
RESULTS
25,569 patients were eligible, of whom 12,227 had a confirmed cancer diagnosis. Mean age was 68.5 years and 12,356 patients (48.3%) were women. Concurrent medical conditions of interest were documented in 14,887 patients, most frequently rheumatoid arthritis (n = 4185) and asthma (n = 3085). Yearly bone densitometry was performed in 6.5% (n = 865) of the cancer-free subgroup; 51.8% (n = 6905) were prescribed an osteoporosis treatment, most frequently bisphosphonates (n = 5132; 74.3%). Between 2011 and 2018, rates of densitometry were stable, whereas prescription rates increased from 40.0 to 51.8%.
CONCLUSION
In spite of publication of guidelines for GIOP management, there is an important treatment gap in their application in everyday practice. For this reason, public health measures to increase physician awareness of GIOP are needed.
DOI: 10.1007/s00774-021-01236-z
PubMed: 34125296
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Ltd, 3-5-1, Nihonbashi Honcho, Chuo-ku, Tokyo, Japan. kaku.miki.uc@daiichisankyo.co.jp.</nlm:affiliation><country xml:lang="fr">Japon</country><wicri:regionArea>Primary Medical Science Department, Medical Affairs Division, Japan Business Unit, Daiichi Sankyo Co. Ltd, 3-5-1, Nihonbashi Honcho, Chuo-ku, Tokyo</wicri:regionArea><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region></placeName></affiliation></author><author><name sortKey="Okubo, Naoki" sort="Okubo, Naoki" uniqKey="Okubo N" first="Naoki" last="Okubo">Naoki Okubo</name><affiliation wicri:level="3"><nlm:affiliation>Data Intelligence Department, Digital Transformation Management Division, Daiichi Sankyo Co. Ltd, Tokyo, Japan.</nlm:affiliation><country xml:lang="fr">Japon</country><wicri:regionArea>Data Intelligence Department, Digital Transformation Management Division, Daiichi Sankyo Co. Ltd, Tokyo</wicri:regionArea><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region></placeName></affiliation></author><author><name sortKey="Touzeni, Salsabil" sort="Touzeni, Salsabil" uniqKey="Touzeni S" first="Salsabil" last="Touzeni">Salsabil Touzeni</name><affiliation wicri:level="3"><nlm:affiliation>Health Economics and Outcomes Research, Creativ-Ceutical, Tunis, Tunisia.</nlm:affiliation><country xml:lang="fr">Tunisie</country><wicri:regionArea>Health Economics and Outcomes Research, Creativ-Ceutical, Tunis</wicri:regionArea><placeName><settlement type="city">Tunis</settlement><region nuts="2">Gouvernorat de Tunis</region></placeName></affiliation></author><author><name sortKey="Saito, Kengo" sort="Saito, Kengo" uniqKey="Saito K" first="Kengo" last="Saito">Kengo Saito</name><affiliation wicri:level="3"><nlm:affiliation>Primary Medical Science Department, Medical Affairs Division, Japan Business Unit, Daiichi Sankyo Co. Ltd, 3-5-1, Nihonbashi Honcho, Chuo-ku, Tokyo, Japan.</nlm:affiliation><country xml:lang="fr">Japon</country><wicri:regionArea>Primary Medical Science Department, Medical Affairs Division, Japan Business Unit, Daiichi Sankyo Co. Ltd, 3-5-1, Nihonbashi Honcho, Chuo-ku, Tokyo</wicri:regionArea><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region></placeName></affiliation></author><author><name sortKey="Kobayashi, Makiko" sort="Kobayashi, Makiko" uniqKey="Kobayashi M" first="Makiko" last="Kobayashi">Makiko Kobayashi</name><affiliation wicri:level="3"><nlm:affiliation>Primary Medical Science Department, Medical Affairs Division, Japan Business Unit, Daiichi Sankyo Co. Ltd, 3-5-1, Nihonbashi Honcho, Chuo-ku, Tokyo, Japan.</nlm:affiliation><country xml:lang="fr">Japon</country><wicri:regionArea>Primary Medical Science Department, Medical Affairs Division, Japan Business Unit, Daiichi Sankyo Co. Ltd, 3-5-1, Nihonbashi Honcho, Chuo-ku, Tokyo</wicri:regionArea><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region></placeName></affiliation></author></analytic><series><title level="j">Journal of bone and mineral metabolism</title><idno type="eISSN">1435-5604</idno><imprint><date when="2021" type="published">2021</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>INTRODUCTION</b></p><p>Glucocorticoid-induced osteoporosis (GIOP) is associated with a high fracture risk. Practice guidelines by the Japanese Society for Bone and Mineral Research in 2014 recommend bone densitometry and appropriate treatment to reduce this risk. The study objectives were to describe characteristics of GIOP patients in Japan and to evaluate their management in a subgroup of patients without comorbid cancer.</p></div><div type="abstract" xml:lang="en"><p><b>MATERIALS AND METHODS</b></p><p>This retrospective cohort study was performed using the Medical Data Vision (MDV) database from Japan. Adult patients initiating oral glucocorticoid treatment with a total GIOP risk score ≥ 3, based on the 2014 practice guideline, identified between 2009 and 2019 were eligible. A subgroup of patients without any cancer diagnosis was also identified. Data were extracted on demographics, concurrent medical conditions, use of bone densitometry, and osteoporosis treatment.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>25,569 patients were eligible, of whom 12,227 had a confirmed cancer diagnosis. Mean age was 68.5 years and 12,356 patients (48.3%) were women. Concurrent medical conditions of interest were documented in 14,887 patients, most frequently rheumatoid arthritis (n = 4185) and asthma (n = 3085). Yearly bone densitometry was performed in 6.5% (n = 865) of the cancer-free subgroup; 51.8% (n = 6905) were prescribed an osteoporosis treatment, most frequently bisphosphonates (n = 5132; 74.3%). Between 2011 and 2018, rates of densitometry were stable, whereas prescription rates increased from 40.0 to 51.8%.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSION</b></p><p>In spite of publication of guidelines for GIOP management, there is an important treatment gap in their application in everyday practice. For this reason, public health measures to increase physician awareness of GIOP are needed.</p></div></front></TEI><pubmed><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">34125296</PMID><DateRevised><Year>2021</Year><Month>06</Month><Day>14</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1435-5604</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2021</Year><Month>Jun</Month><Day>14</Day></PubDate></JournalIssue><Title>Journal of bone and mineral metabolism</Title><ISOAbbreviation>J Bone Miner Metab</ISOAbbreviation></Journal><ArticleTitle>Epidemiology of glucocorticoid-induced osteoporosis and management of associated fracture risk in Japan.</ArticleTitle><ELocationID EIdType="doi" ValidYN="Y">10.1007/s00774-021-01236-z</ELocationID><Abstract><AbstractText Label="INTRODUCTION" NlmCategory="BACKGROUND">Glucocorticoid-induced osteoporosis (GIOP) is associated with a high fracture risk. Practice guidelines by the Japanese Society for Bone and Mineral Research in 2014 recommend bone densitometry and appropriate treatment to reduce this risk. The study objectives were to describe characteristics of GIOP patients in Japan and to evaluate their management in a subgroup of patients without comorbid cancer.</AbstractText><AbstractText Label="MATERIALS AND METHODS" NlmCategory="METHODS">This retrospective cohort study was performed using the Medical Data Vision (MDV) database from Japan. Adult patients initiating oral glucocorticoid treatment with a total GIOP risk score ≥ 3, based on the 2014 practice guideline, identified between 2009 and 2019 were eligible. A subgroup of patients without any cancer diagnosis was also identified. Data were extracted on demographics, concurrent medical conditions, use of bone densitometry, and osteoporosis treatment.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">25,569 patients were eligible, of whom 12,227 had a confirmed cancer diagnosis. Mean age was 68.5 years and 12,356 patients (48.3%) were women. Concurrent medical conditions of interest were documented in 14,887 patients, most frequently rheumatoid arthritis (n = 4185) and asthma (n = 3085). Yearly bone densitometry was performed in 6.5% (n = 865) of the cancer-free subgroup; 51.8% (n = 6905) were prescribed an osteoporosis treatment, most frequently bisphosphonates (n = 5132; 74.3%). Between 2011 and 2018, rates of densitometry were stable, whereas prescription rates increased from 40.0 to 51.8%.</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">In spite of publication of guidelines for GIOP management, there is an important treatment gap in their application in everyday practice. For this reason, public health measures to increase physician awareness of GIOP are needed.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Soen</LastName><ForeName>Satoshi</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Soen Orthopaedics, Osteoporosis and Rheumatology Clinic, Kobe, Japan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kaku</LastName><ForeName>Miki</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Primary Medical Science Department, Medical Affairs Division, Japan Business Unit, Daiichi Sankyo Co. Ltd, 3-5-1, Nihonbashi Honcho, Chuo-ku, Tokyo, Japan. kaku.miki.uc@daiichisankyo.co.jp.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Okubo</LastName><ForeName>Naoki</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>Data Intelligence Department, Digital Transformation Management Division, Daiichi Sankyo Co. Ltd, Tokyo, Japan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Touzeni</LastName><ForeName>Salsabil</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Health Economics and Outcomes Research, Creativ-Ceutical, Tunis, Tunisia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Saito</LastName><ForeName>Kengo</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Primary Medical Science Department, Medical Affairs Division, Japan Business Unit, Daiichi Sankyo Co. Ltd, 3-5-1, Nihonbashi Honcho, Chuo-ku, Tokyo, Japan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kobayashi</LastName><ForeName>Makiko</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Primary Medical Science Department, Medical Affairs Division, Japan Business Unit, Daiichi Sankyo Co. Ltd, 3-5-1, Nihonbashi Honcho, Chuo-ku, Tokyo, Japan.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2021</Year><Month>06</Month><Day>14</Day></ArticleDate></Article><MedlineJournalInfo><Country>Japan</Country><MedlineTA>J Bone Miner Metab</MedlineTA><NlmUniqueID>9436705</NlmUniqueID><ISSNLinking>0914-8779</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Epidemiology</Keyword><Keyword MajorTopicYN="N">Glucocorticoids</Keyword><Keyword MajorTopicYN="N">Japan</Keyword><Keyword MajorTopicYN="N">Management</Keyword><Keyword MajorTopicYN="N">Osteoporosis</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2021</Year><Month>03</Month><Day>31</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2021</Year><Month>05</Month><Day>05</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2021</Year><Month>6</Month><Day>14</Day><Hour>12</Hour><Minute>37</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2021</Year><Month>6</Month><Day>15</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2021</Year><Month>6</Month><Day>15</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>aheadofprint</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">34125296</ArticleId><ArticleId IdType="doi">10.1007/s00774-021-01236-z</ArticleId><ArticleId IdType="pii">10.1007/s00774-021-01236-z</ArticleId></ArticleIdList><ReferenceList><Reference><Citation>Saag KG (2014) Bone safety of low-dose glucocorticoids in rheumatic diseases. 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