Many Dermatology Patients on Steroids Not Checked for Bone Loss
By Reuters Staff
NEW YORK (Reuters Health) - Patients on long-term steroids for dermatologic indications are often not evaluated for glucocorticoid-induced osteoporosis (GIOP), new single-center research suggests.
“It is imperative that dermatologists, as frequent prescribers of corticosteroids, make appropriate referrals or pharmacologically treat these patients for GIOP prevention,” Dr. Cassondra Andreychik Ellison and colleagues from Geisinger Medical Center in Danville, Pennsylvania, write in the Journal of the American Academy of Dermatology, online February 12.
Significant bone loss occurs during the first three to six months that patients are on systemic glucocorticoids, underscoring the importance of early treatment, Dr. Ellison and her team note. Dermatologists are known to underuse bisphosphonates for osteoporosis prophylaxis, they add.
The researchers investigated how often patients on long-term glucocorticoids were referred to their hospital’s high-risk osteoporosis clinic (HIROC), where treatment includes serial bone-density scans, weight-bearing exercises and fall-prevention education.
Thirty-six of the 84 (42.9%) dermatology patients who were put on long-term glucocorticoid treatment between 2009 and 2012 were referred to the HIROC. Twenty-three referrals were completed; 20 of these patients were switched to a different osteoporosis-prevention treatment, nearly all of them to bisphosphonates.
“Pharmacies are implementing alerts for patients who receive glucocorticoid therapy for 3 or more months,” the authors write. “Future studies may also highlight the role of the primary physician in treating this cohort.”
J Am Acad Dermatol 2018.
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