A recent survey found that most pediatric rheumatologists do not screen for low bone mineral density on a regular basis for children on long-term glucocorticoid treatment. The survey did find that these rheumatologists often prescribe vitamin D for positive bone health.
Glucocorticoids are a common treatment used to stop inflammation and swelling. However, glucocorticoids accelerate bone loss and put patients at an increased risk for fractures and osteoporosis.
Low bone mineral density (BMD) is common among patients with rheumatologic diseases such as arthritis and lupus even before treatment with glucocorticoids. For this reason, patients with rheumatologic diseases need to have their BMD consistently monitored and managed.
Researchers from University of Illinois surveyed 86 physicians who practice pediatric rheumatology. The physicians were asked questions regarding how they monitor, prevent, and manage BMD for children at risk for low bone density due to long-term glucocorticoid treatment.
The questionnaire reported that 79% never or rarely obtained BMD measurement before the initiation of long-term glucocorticoid treatment, and only 2% of the physicians stated that they always obtained a BMD before the initiation of glucocorticoids.
Forty-six percent of physicians reported that they would consider measures to identify or prevent bone loss in patients taking any steroid dose.
The researchers conclude, “Most respondents do not screen for low BMD on a regular basis despite acknowledging the risks of bone loss in this population.”