A Comparison of Three Different Guidelines for Osteoporosis Treatment in Patients with Rheumatoid Arthritis in Korea
The Korean Journal of Internal Medicine
;
: 436-446, 2010.
Artigo
em Inglês
| WPRIM
| ID: wpr-192807
ABSTRACT
BACKGROUND/AIMS:
Osteoporotic fractures are an important comorbidity with rheumatoid arthritis (RA). We determined the overall fracture risk as assessed by the World Health Organization (WHO)'s FRAX(R) tool in Korean patients with seropositive RA. Additionally, we compared treatment eligibility according to the criteria of the Korean Health Insurance Review Agency (HIRA), FRAX, and the National Osteoporosis Foundation (NOF).METHODS:
Postmenopausal women and men > or = 50 years of age with seropositive RA were recruited from one rheumatism center in Korea. The FRAX score was estimated using the Japanese model. Patients were classified as eligible for treatment using the HIRA, NOF, and FRAX thresholds for intervention.RESULTS:
The study of 234 patients included 40 men (17%). The mean age was 60 +/- 9 years, and 121 (52%) patients had osteoporosis according to the WHO criteria. The overall median 10-year fracture risk was 13% for major osteoporotic fractures and 3.5% for hip fractures. HIRA guidelines identified 130 patients (56%) eligible for treatment, FRAX included 126 patients (54%), and 151 patients (65%) were included according to NOF guidelines. Older patients with a greater number of risk factors were included by FRAX compared to HIRA. The overall concordance between HIRA and FRAX, expressed as the kappa index, was 0.67, but was as low as 0.44 when limited to patients > or = 60 years of age.CONCLUSIONS:
One-half of the patients had osteoporosis requiring treatment. RA patients have a high risk of fracture, and the adoption of a risk-scoring system should be considered.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Osteoporose
/
Artrite Reumatoide
/
Densidade Óssea
/
Prevalência
/
Estudos Transversais
/
Guias de Prática Clínica como Assunto
/
Fraturas por Osteoporose
/
Fraturas do Quadril
/
Coreia (Geográfico)
Tipo de estudo:
Guia de Prática Clínica
/
Estudo observacional
/
Estudo de prevalência
/
Estudo prognóstico
/
Fatores de risco
Limite:
Idoso
/
Feminino
/
Humanos
/
Masculino
País/Região como assunto:
Ásia
Idioma:
Inglês
Revista:
The Korean Journal of Internal Medicine
Ano de publicação:
2010
Tipo de documento:
Artigo
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