The Relationship of Lowering the Values of Bone Mineral Density in Methylprednisolone Medication Adherence on Rheumatoid Arthritis and Systemic Lupus Erythematosus Patients
Journal Title: Indonesian Journal of Clinical Pharmacy - Year 2018, Vol 7, Issue 2
Abstract
Methylprednisolone is a glucocorticoid which has a side effect of decreasing bone mineral density (DMT). The degree of compliance relates to the occurrence of effects. The objective of this study was to investigate the association of DMT impairment with adherence to methylprednisolone therapy in patients with rheumatoid arthritis (AR) and systemic lupus erythematosus (LES). The research was conducted to 43 patients in Rheumatology Polyclinic of dr. Saiful Anwar (RSSA) Malang. The study was conducted in December 2016–January 2017 and included nonexperimental description with qualitative and quantitative analysis using cross sectional method. The data were taken from the patient’s medical record and interview. The inclusion criteria in this research were women, aged 31–50 years, using metilprednisolon therapy for at least three months and have mineral bone density data. Exclusion criteria were menopause, history of bone fracture, smoking, alcohol consumption, cushing syndrome, hyperthyroidism, hyperparathyroidism, pituitary gland disorders, and osteoarthritis and taking drugs bisphosphonates, heparin, anti-convulsants, and thiazid. Data analysis used person correlation and linear regression. There was a significant correlation between adherence to the Spine-L1 DMT area (r= –0.313; p=0.041), Spine-L2 (r= –0.349; p=0.022), Spine-L3 (r = –0.375; p=0.013), and total spine (r= –0.380; p=0.012). Methylprednisolone is sensitive to trabecular bone tissue that makes up the lumbar spine area compared to cortical bone. The low association (r) between adherence and DMT is due to socioeconomic, health care, disease characteristics, and genetics. Compliance of methylprednisolone therapy decreases the value of DMT (lumbar spine) which increased in osteoporosis.
Authors and Affiliations
Anisyah Achmad, Bagus P. P. Suryana, Niela R. Amalia
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