The Korean journal of internal medicine

  • 제25권4호
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  • Pages.436-446
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  • 2010
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  • 1226-3303(pISSN)
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  • 2005-6648(eISSN)
대한내과학회 (The Korean Association of Internal Medicine)
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A Comparison of Three Different Guidelines for Osteoporosis Treatment in Patients with Rheumatoid Arthritis in Korea

  • Yoon, Ji-Yeol (Division of Rheumatology, Department of Internal Medicine, Inha University College of Medicine) ;
  • Kwon, Seong-Ryul (Division of Rheumatology, Department of Internal Medicine, Inha University College of Medicine) ;
  • Lim, Mie-Jin (Division of Rheumatology, Department of Internal Medicine, Inha University College of Medicine) ;
  • Joo, Ko-Woon (Division of Rheumatology, Department of Internal Medicine, Inha University College of Medicine) ;
  • Moon, Chang-Gi (Division of Rheumatology, Department of Internal Medicine, Inha University College of Medicine) ;
  • Jang, Ji-Hun (Division of Rheumatology, Department of Internal Medicine, Inha University College of Medicine) ;
  • Park, Won (Division of Rheumatology, Department of Internal Medicine, Inha University College of Medicine)
  • 투고 : 2010.06.27
  • 심사 : 2010.08.26
  • 발행 : 2010.12.01
⟨ 이전 논문 다음 논문 ⟩

초록

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 ${\geq}$ 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 $60{\pm}9$ 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 ${\geq}$ 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.

키워드

참고문헌

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피인용 문헌

  1. Bone Mineral Density Changes in Patients with Recent-Onset Rheumatoid Arthritis vol.4, pp.None, 2010, https://doi.org/10.4137/cmamd.s7773
  2. Increased frequency of osteoporosis and BMD below the expected range for age among South Korean women with rheumatoid arthritis vol.15, pp.3, 2010, https://doi.org/10.1111/j.1756-185x.2012.01729.x
  3. The Risk of Osteoporotic Fractures According to the FRAX Model in Korean Patients with Rheumatoid Arthritis vol.29, pp.8, 2014, https://doi.org/10.3346/jkms.2014.29.8.1082
  4. Proper time to initiate antiosteoporotic treatment in rheumatoid arthritis with or without glucocorticoid use vol.29, pp.4, 2010, https://doi.org/10.3904/kjim.2014.29.4.434
  5. Rheumatoid arthritis patients with hip fracture: a nationwide study vol.26, pp.2, 2010, https://doi.org/10.1007/s00198-014-2968-y
  6. A systematic review of intervention thresholds based on FRAX : A report prepared for the National Osteoporosis Guideline Group and the International Osteoporosis Foundation vol.11, pp.1, 2010, https://doi.org/10.1007/s11657-016-0278-z
  7. The frequency of and risk factors for osteoporosis in Korean patients with rheumatoid arthritis vol.17, pp.None, 2010, https://doi.org/10.1186/s12891-016-0952-8
  8. Lean Mass and Disease Activity are the Best Predictors of Bone Mineral Loss in the Premenopausal Women with Rheumatoid Arthritis vol.22, pp.2, 2010, https://doi.org/10.4103/ijem.ijem_665_17