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Glucocorticoid-induced Osteoporosis in Patients With Chronic Inflammatory Rheumatic Diseases or Psoriasis

Recruiting
Conditions
Osteoporosis
Inflammatory Rheumatism
Interventions
Drug: Glucocorticoid treatment
Registration Number
NCT02719314
Lead Sponsor
Prof Dr Frank Buttgereit
Brief Summary

Glucocorticoids remain to be among the most important and most frequently used anti-inflammatory and immunosuppressive or immune-modulatory acting drugs to treat rheumatic (and other) diseases. Unfortunately, glucocorticoids also exert undesired effects, especially if higher dosages have to be given over longer periods of time. The available data describing frequency and severity of these adverse effects are fragmentary. This statement is especially true for glucocorticoid-induced osteoporosis (GIOP) in the context of chronic inflammatory rheumatic diseases or (in part) psoriasis(arthritis). The state of knowledge and scientific data, being sparse, is partly conflicting and often derived from over-aged projects or studies. Therefore, there are urgent needs to work on various current questions systematically and at the highest scientific level possible. In order to address these needs, we aim at collecting and analyzing disease- and bone-related data from patients with chronic inflammatory rheumatic diseases or psoriasis and therapy with glucocorticoids, and to build a respective GIOP-Databank. Patients will attend for diagnostics, and where necessary therapy and follow-up of GIOP, according to current guidelines. Clinical, laboratory and instrumental examination results from more than 1000 patients in the first three years of the project are planned to be documented in a prospective database.

Detailed Description

Glucocorticoids remain to be among the most important and most frequently used anti-inflammatory and immunosuppressive or immune-modulatory acting drugs to treat rheumatic (and other) diseases. Unfortunately, glucocorticoids also exert undesired effects, especially if higher dosages have to be given over longer periods of time. The available data describing frequency and severity of these adverse effects are fragmentary. This statement is especially true for glucocorticoid-induced osteoporosis (GIOP) in the context of chronic inflammatory rheumatic diseases or (in part) psoriasis(arthritis), since GIOP is counted among the two most important adverse effects of glucocorticoid therapy, by both rheumatologists and patients. The state of knowledge and scientific data, being sparse, is partly conflicting and often derived from over-aged projects or studies. Therefore, there are urgent needs to work on various current questions systematically and at the highest scientific level possible. In order to address these needs, we aim at collecting and analyzing disease- and bone-related data from patients with chronic inflammatory rheumatic diseases or psoriasis and therapy with glucocorticoids, and to build a respective GIOP-Databank. Patients will attend for diagnostics, and where necessary therapy and follow-up of GIOP, according to current guidelines. Clinical, laboratory and instrumental examination results from more than 1000 patients in the first three years of the project are planned to be documented in a prospective database.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
10000
Inclusion Criteria

Every patient has to fulfill the following inclusion criteria:

  • patients with (control group: without) a diagnosis of a chronic inflammatory rheumatic disease or psoriasis
  • patients who (not for control groups) have/had already a glucocorticoid therapy, or patients in which the implementation of a new long-term GC therapy is expected
  • patients who, according to the Dachverband Osteologie (DVO, Germany) guidelines, attend our osteoporosis and bone metabolism outpatient consultation hours or are referred by the hospital wards of the Charité for diagnosis, treatment or follow-up
  • capability to understand the patient information
  • consent to participation in the project and storage of data
Exclusion Criteria

If any of the following exclusion criteria is true, the patient must not be included in this study:

  • alcohol, medication and/or drug addiction
  • severe psychiatric diseases limiting the comprehension of the project plan and the study protocol (persons incapable of giving informed consent)
  • pregnant and lactating patients
  • patients incapable of giving informed consent for any reason
  • prisoners and all persons who are committed to an institution due to an official or judicial order

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Rh-GIOP(A)Glucocorticoid treatmentGlucocorticoid-induced osteoporosis (GIOP) in the context of chronic inflammatory rheumatic diseases
Rh-GIOP(B)Glucocorticoid treatmentGlucocorticoid-induced osteoporosis (GIOP) in the context of psoriasis
Primary Outcome Measures
NameTimeMethod
Bone mineral density2 - 5 years

T-score (measured by DEXA; statistical evaluation on group levels, lower values are considered as being more dangerous)

Secondary Outcome Measures
NameTimeMethod
Cumulative glucocorticoid dosageat least 1 day - 25 years

Cumulative glucocorticoid dosage in gram (measured by questionnaire; summed values are calculated; statistical evaluation on group levels, higher values are considered as being more dangerous)

Mean daily glucocorticoid dosage1 day - 25 years

Mean daily dosage in milligram prednisone equivalent per day (measured by questionnaire; averaged values are calculated; statistical evaluation on group levels, higher values are considered as being more dangerous)

Duration of glucocorticoid dosagefrom 1 day - 25 years

Duration of glucocorticoid therapy in days (measured by questionnaire; statistical evaluation on group levels; higher values are considered as being more dangerous)

Trial Locations

Locations (1)

Charité University Medicine Berlin (CCM)

🇩🇪

Berlin, Germany

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