Management of bone health in idiopathic inflammatory myopathies: A two-center audit in the United Kingdom and Hong Kong.
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Authors
Thumbe, Akanksha
Kumar, Aman
Ajibade, Adeola
Sapkota, Hem
Sheeran, Thomas P
Venkatachalam, Srinivasan
So, Ho
Gupta, Latika
Issue Date
2024-Sep
Type
Journal Article
Multicenter Study
Multicenter Study
Language
en
Keywords
DXA , FRAX , bisphosphonates , fragility fracture , myositis , osteopenia , osteoporosis
Alternative Title
Abstract
Background: Patients with inflammatory idiopathic myopathies (IIM) face elevated risks of osteoporosis and fragility fracture.
Aim: To evaluate current practice relating to bone health in adult patients with IIM in the United Kingdom and Hong Kong (HK).
Methods: Patients were identified from IIM patient lists. Demographics, osteoporosis risk factors, DXA scans, and bone protection treatment were recorded. Adherence to regional standards was evaluated for each center. Following this, in the United Kingdom, up-to-date DXA scans were performed.
Results: Of 136 patients identified, 51 met selection criteria (UK, n = 20, HK, n = 31). Mean age in the United Kingdom was 59 (IQR 54-66); in Hong Kong, 65 (IQR 52.5-70). Most were female (UK 70%; HK 77%), current or previous steroid treatment was common (UK 90%; HK 100%) and some had experienced fragility fracture (UK 15%; HK 9%). The mean daily dose of prednisolone that patients were prescribed during the study was 12.5 mg (UK) and 14.3 mg (HK). Some patients had had a DXA scan (UK 50%; HK 35%) though several were outdated. Among those with BMD measured (UK, n = 20; HK, n = 11), osteopenia prevalence was 35% (UK) and 36% (HK) while osteoporosis was 5% (UK) and 36% (HK). Notably, 25% (UK) and 64% (HK) exceeded treatment thresholds. Treatments included anti-osteoporotic agents (UK 55%; HK 15%), Vitamin D/calcium supplements (UK 95%; HK 52%), or no treatment (UK 5%, HK 15%).
Conclusion: Poor compliance with guidelines exists in both centers, particularly around investigation and monitoring of bone health for IIM patients. Integrated care models and increased resource allocation to bone health are imperative to improve management of this aspect of IIM.
Description
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium,provided the original work is properly cited.© 2024 The Author(s). International Journal of Rheumatic Diseases published by Asia Pacific League of Associations for Rheumatology and John Wiley & SonsAustralia, Ltd.
Citation
Thumbe, A. et al. (2024) 'Management of bone health in idiopathic inflammatory myopathies: A two-center audit in the United Kingdom and Hong Kong', International Journal of Rheumatic Diseases 27(9) e15268. Available At: https://doi.org/10.1111/1756-185x.15268
Publisher
Wiley
License
© 2024 The Author(s). International Journal of Rheumatic Diseases published by Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.
Journal
International journal of rheumatic diseases
Volume
27
Issue
9
PubMed ID
ISSN
1756-185X