AB0855 FACTORS ASSOCIATED WITH ADHERENCE TO OSTEOPOROSIS TREATMENT IN PATIENTS WITH RHEUMATIC DISEASES

Abstract

Background Patients with rheumatic diseases (RD) have an increased risk of developing osteoporosis (OP) and fractures compared with healthy population due to chronic inflammation, low physical activity and using some kind of medications. Persistence and adherence to OP therapy are important factors in achieving successful outcomes in fracture reduction. Objectives To identify the factors affecting persistence and adherence to OP therapy in patients with RD Methods We conducted observational study of 196 RD (150 - with rheumatoid arthritis and 46 - with systemic sclerosis) patients aged 50 years and older (96% women, mean age 61±9 years) with OP. Persistence and adherence were assessed 3 years after OP therapy initiation. The patients kept a diary on osteoporosis therapy. The information was collected during the visits to the doctor or from telephone contact with the patient every year. Results During 3 years 32% of patients received zoledronic acid, 27% - alendronate, 16% - denosumab, 12%- ibandronate, 5% - alfacalcidol, 3% - strontium ranelate, 1% - teriparatide, 3% - calcium and vitamin D. 45 (23%) persons were switched from one antiosteoporotic medication to another due to physician’s recommendation. 123 patients (63%) were persistent with OP therapy, including 78% of those who received zoledronic acid, 75% - denosumab, 60% - oral bisphosphonates, 53% - among those, who switched OP therapy during follow up period. The most common reason for interruption or discontinuation of OP treatment was poor tolerance (33%). Persistence in patients with RD was associated with determination of vitamin D level (OR =3.84, 95%CI 1.91-7.72, p=0.0001), 10 years fracture risk assessment (FRAX®) (OR=3.9, 95%CI 1.4-10.9 p=0.006), annual BMD measurement (OR=2.19, 95%CI 1.08-4.42, p=0.028), quantity of biochemical blood tests (p=0.0043) and visits to the doctor (p=0.003). Age, education, marital status, income level, duration of disease, educational brochures and lectures on OP, previous fractures, hip fractures in parents, the number of comorbidities, the total number of taken medications did not affect adherence and persistence to OP treatment. Conclusion 63% of patients with RD and OP received antiosteoporotic medication during 3 years. Assessment of serum vitamin D level and FRAX score, monitoring of OP therapy with annual DEXA, blood biochemical markers and regular visits to the rheumatologist associated with increased persistence with OP treatment in RD patients. Disclosure of Interests Oxana Nikitinskaya Speakers bureau: Amgen, Natalia Toroptsova Speakers bureau: Amgen, Lilly