Low prevalence of bone mineral density testing in patients with systemic lupus erythematosus and glucocorticoid exposure

Summary Patients with systemic lupus erythematosus (SLE) have an increased risk of developing osteoporosis and fractures due to systemic inflammation and glucocorticoids (GCs). Professional organizations recommend bone mineral density (BMD) testing in SLE patients on GCs, especially within 6 months...

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Bibliographic Details
Published in:Lupus 2021-03, Vol.30 (3), p.403-411
Main Authors: Boone, JB, Wheless, Lee, Camai, Alex, Tanner, S Bobo, Barnado, April
Format: Article
Language:English
Subjects:
Bone density
Bone mineral density
Electronic medical records
Ethnicity
Fractures
Glucocorticoids
Inflammation
Lupus
Minority & ethnic groups
Nephritis
Osteoporosis
Systemic lupus erythematosus
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Summary:Summary Patients with systemic lupus erythematosus (SLE) have an increased risk of developing osteoporosis and fractures due to systemic inflammation and glucocorticoids (GCs). Professional organizations recommend bone mineral density (BMD) testing in SLE patients on GCs, especially within 6 months of initiation. Using a validated algorithm, we identified SLE patients in an electronic health record cohort with long-term GC exposure (≥90 days). Our primary outcome was ever BMD testing. We assessed the impact of patient and provider factors on testing. We identified 693 SLE cases with long-term GC exposure, 41% of whom had BMD testing performed. Only 18% of patients had BMD testing within 6 months of GC initiation. In a logistic regression model for BMD testing, male sex (OR = 0.49, 95% CI 0.27 – 0.87, p = 0.01) was associated with being less likely to have BMD testing after adjusting for race and ethnicity. In contrast, older age (OR = 1.04, p 
ISSN:0961-2033
1477-0962
DOI:10.1177/0961203320979735