Rehabilitation Unit, Helsinki University Central Hospital, Finland.
Clin Exp Rheumatol. 2011 Sep-Oct;29(5):835-8. Epub 2011 Oct 31.
We investigated the implementation of pharmaceutical osteoporosis (OP) prevention in early rheumatoid arthritis (RA) in Finland.
All incident RA cases from 2000 to 2007 were identified using the national register of the Social Insurance Institution (SII) as the sole source. The use of calcium and vitamin D preparations and OP drugs during the first year was evaluated.
A total of 14,878 incident RA patients were found. They had a mean age of 56 (SD 15) and 68% were female. Nine per cent of the total number, which equated to 11% for women and to 5% men, had purchased OP drugs. The use of OP drugs increased over time: in the 2006-2007 period, relative risk (RR) for purchase was 1.62 (95% CI 1.38-1.92) for women and 2.1 (1.34-3.30) for men compared to the 2000-2001 period. Over the 2000-2005 period, 49% of females and 52% of males used glucocorticoids (GCs) during the first year. Among the GC-users, 38% of women and 24% of men also received calcium and vitamin D preparations by prescription, and 14% of women and 6% of men also used OP drugs. For GC users, the female sex, and older age increased the risk for OP use: the respective RRs were 1.45 (95% CI 1.31-1.61), 2.54 (95% CI 2.21-2.91), and 1.060 (95% CI 1.057-1.065).
Patients with early RA are increasingly receiving OP drugs, and the use is more frequent among patients with known risk factors.
我们研究了芬兰在早期类风湿关节炎(RA)中实施药物性骨质疏松症(OP)预防的情况。
利用国家社会保险机构(SII)的登记系统作为唯一来源,确定了 2000 年至 2007 年期间所有新发 RA 病例。评估了患者在第一年中使用钙和维生素 D 制剂以及 OP 药物的情况。
共发现 14878 例新发 RA 患者,平均年龄 56(SD 15)岁,68%为女性。总人数的 9%(女性为 11%,男性为 5%)购买了 OP 药物。OP 药物的使用随时间而增加:在 2006-2007 年期间,与 2000-2001 年相比,女性购买 OP 药物的相对风险(RR)为 1.62(95% CI 1.38-1.92),男性为 2.1(1.34-3.30)。在 2000-2005 年期间,49%的女性和 52%的男性在第一年中使用了糖皮质激素(GC)。在 GC 使用者中,38%的女性和 24%的男性还按处方使用了钙和维生素 D 制剂,14%的女性和 6%的男性还使用了 OP 药物。对于 GC 使用者,女性性别和年龄较大增加了 OP 使用的风险:相应的 RR 分别为 1.45(95% CI 1.31-1.61)、2.54(95% CI 2.21-2.91)和 1.060(95% CI 1.057-1.065)。
早期 RA 患者越来越多地接受 OP 药物治疗,并且在已知有风险因素的患者中使用更为频繁。