AN AUSTRALIAN review into the monitoring of long-term effects of corticosteroids has renewed a call for clinicians, pharmacists and patients to work together and take preventative steps to minimise risk of bone loss and fracture, particularly in older people.
The findings, published in the Journal of Pharmacy Practice and Research (JPPR), the flagship research publication of the Society of Hospital Pharmacists of Australia (SHPA), advised risk monitoring, vitamin D and calcium supplements and fracture prevention therapy should be considered when oral corticosteroids are used for longer than one month.
Corticosteroids are commonly prescribed to mitigate chronic inflammatory or autoimmune disorders, including rheumatoid arthritis and chronic obstructive pulmonary disease (COPD), among others, the authors explained.
Lead author Dr Kerrie Westaway from the School of Pharmacy and Medical Sciences at the University of South Australia says identifying risks and balancing them with the benefits of treatment is crucial when considering long-term oral corticosteroid therapy.
"Corticosteroids can provide welcome relief, but when taken orally for prolonged periods at prednisolone-equivalent doses greater than 5mg per day, they are associated with a high incidence of bone loss and muscle atrophy and weakness," Westaway wrote.
Australian Department of Veterans' Affairs health data shows many older people are not receiving a bone mineral density test or medicines for osteoporosis prevention when receiving long-term oral corticosteroids.
"To minimise risk of bone fracture, at-risk patients should be promptly identified and preventive measures, including calcium and vitamin D supplements and fracture prevention therapy, should be considered," Westaway added.
CLICK HERE to access the abstract.
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