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Prescription for antiresorptive therapy in Mexican patients with rheumatoid arthritis: is it time to reevaluate the strategies for osteoporosis prevention?

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Abstract

Glucocorticoids are frequently used in rheumatoid arthritis (RA) in order to alleviate symptoms of joint inflammation, retard erosions and to treat extra-articular manifestations, although these drugs may increase the risk of bone mineral loss and osteoporotic fractures. To date, in Mexico there are no studies that identify the frequency of patients with RA with corticosteroids, receiving therapy for osteoporosis. Therefore, we evaluated the prevalence and factors related to the prescription of antiresorptives in 520 Mexican patients with RA. We used a multivariate model to identify variables associated with antiresorptives prescription. We identified that although 79% of patients were under treatment with glucocorticoids, only 13% received antiresorptive agents as preventive therapy for osteoporosis. The multivariate analysis identified that higher proportions of antiresorptive drugs prescriptions were associated with female patients (OR 11.40, 95% CI: 1.5–84.3, P = 0.02), an age of 40 years or more (OR 3.22, 95% CI: 1.3–8.3, P = 0.02) and to consume a lower number of cointerventions with other drugs (OR 1.09, 95% CI: 1.0–1.2, P = 0.03). Corticosteroid treatment was not associated with the prescription of antiresorptives (P = 0.31). In conclusion, a low proportion of Mexicans with RA receive antiresorptive therapy independently regardless of whether they consume or not chronically corticosteroids. Additional strategies should be evaluated to encourage the prevention and early treatment for osteoporosis in patients with RA.

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Authors and Affiliations

  1. Unidad de Investigación en Epidemiología Clínica, Instituto Mexicano del Seguro Social (IMSS) Hospital de Especialidades Centro Médico Nacional de Occidente, Guadalajara, Mexico

    J. I. Gamez-Nava, M. L. Vazquez-Villegas, N. A. Rodriguez-Jimenez, E. M. Olivas-Flores & N. G. Gonzalez-Montoya

  2. Posgrado en Ciencias Biomédicas, Orientación Inmunología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Unidad de Investigación en Epidemiología Clínica, Instituto Mexicano del Seguro Social (IMSS) Hospital de Especialidades Centro Médico Nacional de Occidente, Guadalajara, Mexico

    S. A. Zavaleta-Muñiz

  3. Departamento de Medicina Interna/Reumatología, Hospital General Regional 110 del Instituto Mexicano del Seguro Social (IMSS), Guadalajara, Mexico

    A. Vega-Lopez, A. D. Rocha-Muñoz, M. E. Martinez-Corral & L. Gonzalez-Lopez

  4. Instituto de Reumatología y Enfermedades Musculo-Esqueléticas, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico

    E. G. Corona-Sanchez & B. T. Martin-Márquez

  5. Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico

    J. I. Gamez-Nava, M. Vazquez-Del Mercado, J. F. Muñoz-Valle & L. Gonzalez-Lopez

  6. Departamento de Fisiología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico

    E. G. Cardona-Muñoz

  7. Departamento de Salud Publica, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Unidad de Investigación en Epidemiología Clínica, Instituto Mexicano del Seguro Social (IMSS) Hospital de Especialidades Centro Médico Nacional de Occidente, Guadalajara, Mexico

    A. Celis-De La Rosa

  8. Dirección de Educación e Investigación en Salud, Unidad de Investigación en Epidemiología Clínica, Hospital de Especialidades Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social (IMSS), Guadalajara, Mexico

    C. Cabrera-Pivaral

  9. Avenida Salto del Agua 2192, Col, Jardines del Country, 44210, Guadalajara, Jalisco, Mexico

    L. Gonzalez-Lopez

  10. Posgrado en Ciencias de la Farmacología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico

    N. A. Rodriguez-Jimenez

Authors
  1. J. I. Gamez-Nava
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  2. S. A. Zavaleta-Muñiz
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  3. M. L. Vazquez-Villegas
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  4. A. Vega-Lopez
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  5. N. A. Rodriguez-Jimenez
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  6. E. M. Olivas-Flores
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  7. N. G. Gonzalez-Montoya
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  8. E. G. Corona-Sanchez
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  9. A. D. Rocha-Muñoz
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  10. M. E. Martinez-Corral
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  11. B. T. Martin-Márquez
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  12. M. Vazquez-Del Mercado
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  13. J. F. Muñoz-Valle
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  14. E. G. Cardona-Muñoz
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  15. A. Celis-De La Rosa
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  16. C. Cabrera-Pivaral
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  17. L. Gonzalez-Lopez
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Corresponding author

Correspondence to L. Gonzalez-Lopez.

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Gamez-Nava, J.I., Zavaleta-Muñiz, S.A., Vazquez-Villegas, M.L. et al. Prescription for antiresorptive therapy in Mexican patients with rheumatoid arthritis: is it time to reevaluate the strategies for osteoporosis prevention?. Rheumatol Int 33, 145–150 (2013). https://doi.org/10.1007/s00296-011-2341-9

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  • DOI: https://doi.org/10.1007/s00296-011-2341-9

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