Osteoporosis Treatment in RA Patients is Low, Despite Guidelines

Nearly 50% of rheumatoid arthritis (RA) patients who should be receiving guideline-recommended osteoporosis (OP) treatment do not receive appropriate care, according to the results of a recent study.
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In their study, researchers followed patients with RA or osteoarthritis (OA) from 2003 through 2014, and defined OP treatment as receipt of OP treatment or screening.

Overall, OP treatment or screening was reported in 67.4% of 11,669 patients with RA and 64.6% of 2829 patients with OA during a median follow-up of 5.5 years, and OP medication use was reported by ~55% of patients for whom treatment was indicated by the 2010 ACR glucocorticoid-induced OP guidelines (48.4% of RA and 17.6% of OA patients). A significant downward trend was observed in OP treatment after 2008 in both RA and OA patients.

Older age, postmenopausal state, prior fragility fracture, glucocorticoid treatment, and biologic use were all associated with receipt of OP care in RA patients.

“About half of RA patients for whom treatment was indicated never received a OP medication. OP care in RA patients was not better than OA patients, and the relative risk of application of this care has been decreasing in RA and OA patients since 2008 without improvement after the release of the 2010 ACR GIOP guideline.”

—Michael Potts

Reference:

Ozen G, Kamen DL, Mikuls TR, et al. Trends and determinants of osteoporosis treatment and screening in patients with rheumatoid arthritis compared to osteoarthritis [published online August 3, 2017]. Arthritis Care Research. Doi:10.1002/acr.23331.