Akanksha Thumbe, Aman Kumar, Adeola Ajibade, Hem Sapkota, Thomas P Sheeran, Srinivasan Venkatachalam, Ho So, Latika Gupta
{"title":"特发性炎症性肌病患者的骨骼健康管理:英国和香港的双中心审计","authors":"Akanksha Thumbe, Aman Kumar, Adeola Ajibade, Hem Sapkota, Thomas P Sheeran, Srinivasan Venkatachalam, Ho So, Latika Gupta","doi":"10.1111/1756-185X.15268","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Patients with inflammatory idiopathic myopathies (IIM) face elevated risks of osteoporosis and fragility fracture.</p>\n </section>\n \n <section>\n \n <h3> Aim</h3>\n \n <p>To evaluate current practice relating to bone health in adult patients with IIM in the United Kingdom and Hong Kong (HK).</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Of 136 patients identified, 51 met selection criteria (UK, <i>n</i> = 20, HK, <i>n</i> = 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 Some patients had had a DXA scan (UK 50%; HK 35%) though several were outdated.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, <i>n</i> = 20; HK, <i>n</i> = 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%).</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>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.</p>\n </section>\n </div>","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"27 9","pages":""},"PeriodicalIF":2.4000,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1756-185X.15268","citationCount":"0","resultStr":"{\"title\":\"Management of bone health in idiopathic inflammatory myopathies: A two-center audit in the United Kingdom and Hong Kong\",\"authors\":\"Akanksha Thumbe, Aman Kumar, Adeola Ajibade, Hem Sapkota, Thomas P Sheeran, Srinivasan Venkatachalam, Ho So, Latika Gupta\",\"doi\":\"10.1111/1756-185X.15268\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>Patients with inflammatory idiopathic myopathies (IIM) face elevated risks of osteoporosis and fragility fracture.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Aim</h3>\\n \\n <p>To evaluate current practice relating to bone health in adult patients with IIM in the United Kingdom and Hong Kong (HK).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Of 136 patients identified, 51 met selection criteria (UK, <i>n</i> = 20, HK, <i>n</i> = 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, <i>n</i> = 20; HK, <i>n</i> = 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%).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>Poor compliance with guidelines exists in both centers, particularly around investigation and monitoring of bone health for IIM patients. 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Management of bone health in idiopathic inflammatory myopathies: A two-center audit in the United Kingdom and Hong Kong
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.
期刊介绍:
The International Journal of Rheumatic Diseases (formerly APLAR Journal of Rheumatology) is the official journal of the Asia Pacific League of Associations for Rheumatology. The Journal accepts original articles on clinical or experimental research pertinent to the rheumatic diseases, work on connective tissue diseases and other immune and allergic disorders. The acceptance criteria for all papers are the quality and originality of the research and its significance to our readership. Except where otherwise stated, manuscripts are peer reviewed by two anonymous reviewers and the Editor.