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Ruxandra Ionescu

Ruxandra Ionescu

Preşedinte Societatea Română de Reumatologie
Ruxandra Ionescu

Latest posts by Ruxandra Ionescu (see all)

  • Comparison of non-radiographic spondyloarthritis versus ankylosing spondylitis patients undergoing biological therapy – data from a Romanian cohort - 27/02/2017
  • Assessing anti-TNF trough levels and its applicability in daily practice in spondyloarthritis patients - 18/11/2016
  • PULMONARY NON-HODGKIN LYMPHOMA IN A PRIMARY SJÖGREN SYNDROME PATIENT - 07/08/2016

Articles signed on Romanian Journal of RHEUMATOLOGY:

Comparison of non-radiographic spondyloarthritis versus ankylosing spondylitis patients undergoing biological therapy – data from a Romanian cohort

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Romanian Journal of Rheumatology, Volume XXV, No. 4, 2016
ISSN 1843-0791  |  e-ISSN 2069-6086
ISSN-L 1843-0791
DOI: 10.37897/RJR

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Comparison of non-radiographic spondyloarthritis versus ankylosing spondylitis patients undergoing biological therapy – data from a Romanian cohort

Claudia Deaconu, Daniela Opris and Ruxandra Ionescu

ABSTRACT

Both non-radiographic spondyloarthritis (nr-SpA) and ankylosing spondylitis (AS) are medical conditions that belong to the axial spondyloarthritis spectrum; these two terms reveal the extent of sacroiliitis assessed by conventional x-ray or MRI. According to the latest classification criteria (ASAS, 2009), clinicians are able to differentiate patients with nr-SpA from AS and to follow their disease progression.
The present study aims to compare the two patient categories undergoing biological therapy with an anti-TNF agent and indicate distinct disease features. We included 94 patients in treatment with IFX, ADL, ETA or GOL and monitored clinical, biological and disease activity parameters.
The nr-SpA subgroup included a higher percentage of female patients; AS patients presented higher values of the CRP at follow-up visits; there were no significant differences between the two groups regarding the HLA-B27 presence, uveitis history or smoking status.
Patients with an inactive disease status had a lower BMI, shorter disease duration and an early initiation of biological therapy, so that we suggest a close and regular monitoring of these two entities.

Keywords: non-radiographic spondyloarthritis, ankylosing spondylitis, anti-TNF therapy, radiographic progression, window of opportunity

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Assessing anti-TNF trough levels and its applicability in daily practice in spondyloarthritis patients

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Romanian Journal of Rheumatology, Volume XXV, No. 3, 2016
ISSN 1843-0791  |  e-ISSN 2069-6086
ISSN-L 1843-0791
DOI: 10.37897/RJR

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National Awards “Science and Research”

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ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

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Assessing anti-TNF trough levels and its applicability in daily practice in spondyloarthritis patients

Claudia Deaconu, Daniela Opris and Ruxandra Ionescu

ABSTRACT

Objective. The purpose of the present study was to assess the relevance of therapeutic drug monitoring in spondyloarthritis patients, by determining drug serum levels and anti-drug antibodies and estimating cut-off values for three TNF inhibitors.
Methods. Over one year, we enrolled 100 patients with SpA, under consequent treatment with adalimumab (ADL), etanercept (ETA) or infliximab (IFX). Demographic, clinical (BASDAI, ASDAS) and laboratory (ESR, CRP) data was collected together with drug serum level and anti-drug antibodies using the ELISA technique. The statistical analysis was performed using the SPSS software, version 20.0 with the aid of Student t-test, Spearman and Pearson tests.
Results. Out of the study cohort, 35% were on ADL, 33% on IFX, and 32% under ETA treatment. Undetectable drug levels correlated to the presence of anti-drug antibodies and to disease activity scores. There were no identified anti-ETA antibodies. For this study lot trough levels are estimated between 2 and 4 μg/mL for an ASDAS-CRP under 2.1.
Conclusion. Serum drug level measurement and anti-drug antibody detection can be used as a completion to a clinician’s tools in assessing disease activity, leading to an optimal and personalized manner of patient management.

Keywords: spondyloarthritis, anti-TNF therapy, drug serum level, through level, personalized medicine

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PULMONARY NON-HODGKIN LYMPHOMA IN A PRIMARY SJÖGREN SYNDROME PATIENT

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Romanian Journal of Rheumatology, Volume XXV, No. 2, 2016
ISSN 1843-0791  |  e-ISSN 2069-6086
ISSN-L 1843-0791
DOI: 10.37897/RJR

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HIGHLIGHTS

National Awards “Science and Research”

NEW! RJR has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

The published medical research literature is a global public good. Medical journal editors have a social responsibility to promote global health by publishing, whenever possible, research that furthers health worldwide.

PULMONARY NON-HODGKIN LYMPHOMA IN A PRIMARY SJÖGREN SYNDROME PATIENT

Claudia Deaconu, Ruxandra Ionescu and Daniela Opris

ABSTRACT

Sjögren syndrome (SS) is a chronic autoimmune condition that mainly targets exocrine glands where it produces lymphocytic infiltrates. The clinical display varies in severity and can include malignancy association such as non-Hodgkin lymphoma. Its incidence ranges from 5 to 8%, while the risk of occurrence is 16 to 44 times higher. This article aims to describe the evolution of a patient with primary SS who developed pulmonary lymphoma for which she received Rituximab as part of the oncological therapeutic scheme. During the course of the disease she developed membranous glomerulonephritis, rarely described in these patients and low complement levels cited as predictive factor for lymphoproliferation.

Keywords: Sjögren syndrome, non-Hodgkin lymphoma, autoimmune disease

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OPTIMIZING EXISTING TOOLS FOR REACHING AN ADEQUATE DISEASE CONTROL IN PATIENTS WITH SPONDYLOARTHRITIS

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Romanian Journal of Rheumatology, Volume XXV, No. 2, 2016
ISSN 1843-0791  |  e-ISSN 2069-6086
ISSN-L 1843-0791
DOI: 10.37897/RJR

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HIGHLIGHTS

National Awards “Science and Research”

NEW! RJR has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

The published medical research literature is a global public good. Medical journal editors have a social responsibility to promote global health by publishing, whenever possible, research that furthers health worldwide.

OPTIMIZING EXISTING TOOLS FOR REACHING AN ADEQUATE DISEASE CONTROL IN PATIENTS WITH SPONDYLOARTHRITIS

Claudia Deaconu, Daniela Opris, Diana Mazilu, Laura Groseanu, Andreea Borangiu, Saulescu Ioana, Alexandra Peltea, Magdalena Negru, Cosmin Constantinescu, Violeta Vlad, Violeta Bojinca, Andra Balanescu, Denisa Predeteanu and Ruxandra Ionescu

ABSTRACT

Background/Objective. Disease activity in spondyloarthritis (SpA) is evaluated through conventional scores such as BASDAI or ASDAS. The aim of this study was to determine disease activity in SpA patients under biological therapy with further assessment on the quality of each activity indicator and their clinical value together with their impact on NSAID intake.
Materials and methods. Over nine months (January–August 2015) we enrolled 100 patients with SpA on anti-TNF therapy (33% IFX; 35% ADL; 32% ETA). We collected demographic, clinical (BASDAI, ASDAS, PtGA) and laboratory data (ESR, CRP). Frequency of NSAID ingestion expressed as days per week was included in a questionnaire. Considering their biologic treatment, patients were divided into disease activity groups and sample characteristics were correlated and compared. Statistical analysis was performed with SPSS 20.0, using specific tests such as Pearson, Spearman or ANOVA.
Results. Patients with active disease, stated by both activity scores had an increased NSAID intake. Out of 86% of patients with a BASDAI under 4, only 82.6% had an ASDAS-CRP lower than 1.3. BASDAI correlated to both ASDAS scores (r = 0.65 and 0.71, P<0.001) and PtGA correlated to both disease activity scales, with a stronger correlation to BASDAI (r = 0.912, P<0.01) than ASDAS (r = 0.67 and 0.71, P<0.01 for both).
Conclusion. We proved that disease activity scores have good discriminatory power, with a strong correlation between the subjective BASDAI and PtGA. However, ASDAS-CRP proves to be more rigorous than other variables when targeting high and low disease activity, thus indicating the need of an objective component in assessing these patients.

Keywords: spondyloarthritis, disease activity scores, discriminatory power, anti-TNF therapy

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THE IMMUNOGENICITY ERA – WHAT SHOULD WE KNOW ON ANTI-TNFS IN SPONDYLOARTHRITIS PATIENTS?

SELECT ISSUE

Romanian Journal of Rheumatology, Volume XXV, No. 2, 2016
ISSN 1843-0791  |  e-ISSN 2069-6086
ISSN-L 1843-0791
DOI: 10.37897/RJR

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HIGHLIGHTS

National Awards “Science and Research”

NEW! RJR has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

The published medical research literature is a global public good. Medical journal editors have a social responsibility to promote global health by publishing, whenever possible, research that furthers health worldwide.

THE IMMUNOGENICITY ERA – WHAT SHOULD WE KNOW ON ANTI-TNFS IN SPONDYLOARTHRITIS PATIENTS?

Claudia Deaconu, Daniela Opris and Ruxandra Ionescu

ABSTRACT

Spondyloarthritis (SpA) patients do not respond uniformly to TNF inhibitor therapy, some of them losing their beneficial evolution and becoming primary or secondary non-responders. Hence, questions have been raised whether this situation is linked to predictive genetic factors, individual characteristics or to disease activity. Studies have incriminated immunogenicity as being responsible for the loss or lack of response. It appears that the development of anti-drug antibodies leads to a decrease in drug levels with further impact on patients’ clinical state. This brief review aims to clarify some of the processes involved in the immunogenic phenomenon for patients with SpA, based on the current published literature.

Keywords: spondyloarthritis, anti-TNF therapy, immunogenicity, anti-drug antibodies

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NEURO-BEHÇET’S DISEASE ONSET – A DIAGNOSTIC CHALLENGE

SELECT ISSUE

Romanian Journal of Rheumatology, Volume XXV, No. 1, 2016
ISSN 1843-0791  |  e-ISSN 2069-6086
ISSN-L 1843-0791
DOI: 10.37897/RJR

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HIGHLIGHTS

National Awards “Science and Research”

NEW! RJR has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

The published medical research literature is a global public good. Medical journal editors have a social responsibility to promote global health by publishing, whenever possible, research that furthers health worldwide.

NEURO-BEHÇET’S DISEASE ONSET – A DIAGNOSTIC CHALLENGE

Casandra Buzatu, Sanziana Daia and Ruxandra Ionescu

ABSTRACT

We are presenting the case of a 51 years old female diagnosed with Neuro-Behçet’s disease, undergoing immunosuppression and corticoid therapy in the present. The onset was with recurrent oral ulcerations. Neurological manifestations progressed rapidly from paresthesia in the upper and lower limbs to corset-like hypoesthesia of the abdominal wall and sphincterian incontinence. MRI of the spinal cord showed Transverse Myelitis.

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THERAPEUTIC CHALLENGES AND COMPLICATIONS IN A CASE OF ARTHRITIS MUTILANS

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Romanian Journal of Rheumatology, Volume XXV, No. 1, 2016
ISSN 1843-0791  |  e-ISSN 2069-6086
ISSN-L 1843-0791
DOI: 10.37897/RJR

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DOAJ
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HIGHLIGHTS

National Awards “Science and Research”

NEW! RJR has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

The published medical research literature is a global public good. Medical journal editors have a social responsibility to promote global health by publishing, whenever possible, research that furthers health worldwide.

THERAPEUTIC CHALLENGES AND COMPLICATIONS IN A CASE OF ARTHRITIS MUTILANS

Violeta Bojinca, Raluca Malitchi, Madalina Duna, Cristina Capusa and Ruxandra Ionescu

ABSTRACT

The most dramatic and severe form of arthritis associated with psoriasis is arthritis mutilans (AM), which is a rare disorder, affecting very few patients with psoriasis. AM has a predilection for the small joints of the hands and feet. It is generally characterized by seronegative degenerative joint disease, leading to osteolytic changes in the carpal and digital bones. The bone and joint lesions rapidly and progressively cause bone lysis and joint ankylosis with loss of digits, soft-tissue deformities, telescoping of fingers and toes and the hallmark “la main en lorgnette” deformity (opera-glass hand). Arthritis mutilans is characterized by an asymmetric pattern of peripheral joint involvement, with a predilection for the interphalangeal and metacarpophalangeal joints of the hand and small joints of the feet. Characteristic features of AM are severe deformity of the hands, foreshortened fingers with excessive skin folds, hypermobile joints and digits that can be elongated by traction. Radiologically, AM is characterized by severe resorption of the joint with an attendant loss of function, sometimes to a dramatic degree. We present the case of a male patient who with psoriatic lesions onset from almost four decades, followed by involvement of hand and feet joint with important deformities. The treatment was difficult due to important comorbidities.

Keywords: arthritis mutilans, psoriatic arthropathy, anti TNF-α teraphy

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JUVENILE IDIOPATHIC ARTHRITIS ASSOCIATED WITH INCOMPLETE PRIMARY HYPERTROPHIC OSTEOARTHROPATHY (PACHYDERMOPERIOSTOSIS)

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Romanian Journal of Rheumatology, Volume XXIV, No. 4, 2015
ISSN 1843-0791  |  e-ISSN 2069-6086
ISSN-L 1843-0791
DOI: 10.37897/RJR

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HIGHLIGHTS

National Awards “Science and Research”

NEW! RJR has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

The published medical research literature is a global public good. Medical journal editors have a social responsibility to promote global health by publishing, whenever possible, research that furthers health worldwide.

JUVENILE IDIOPATHIC ARTHRITIS ASSOCIATED WITH INCOMPLETE PRIMARY HYPERTROPHIC OSTEOARTHROPATHY (PACHYDERMOPERIOSTOSIS)

Vasilia Cristina Iorgoveanu, Raluca Ionescu, Laura Groseanu and Ruxandra Ionescu

ABSTRACT

Introduction. Hypertrophic osteoarthropathy (HOA) is a rare, hereditary disease characterized by clubbing and new bone formation in the periosteal region that may be associated with joint pain, cutaneous abnormalities, seborrhea or hyperhydrosis. Juvenile idiopathic arthritis (JIA) is one of the most frequent chronic diseases with childhood onset, patients develop inflammatory joint pain and extra-articular manifestations with imunologic substrate. The association of the two diseases is very rare. 24 years old patient related disease onset at the age of 14 with arthritis of proximal interphalangeal joints (PIP), knees and right ankle. He is diagnosed with oligoarticular form of juvenile idiopathic arthritis. He receives Methotrexate, Suphasalazyne and association of the two, but after 5 years biological therapy with Etanercept is started. Later on, repeated physical examination revealed digital clubbing, non-painful enlargment of hands and feet with sweaty teguments. Radiological examination with subperiosteal new bone formation of the distal tibia, the fibula, the radius, the ulna, the metacarpals and the phalanges confirms the suspicion of HOA – pachydermoperiostosis (PDP).
Conclusion. Final diagnosis considers both entities. The incomplete form of PDP included hands and feet enlargement with extensive periostitis, palmoplantar hyperhydrosis, but no significant facial changes. The specific treatment for JIA did not influence the evolution of PDP.

Keywords: pachydermoperiostosis, hypertrophic osteoarthropathy, juvenile idiopathic arthritis, rheumatoid arthritis, biological therapy

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EFFICACY AND SAFETY OF GOLIMUMAB AS ADD-ON THERAPY TO DISEASE-MODIFYING ANTIRHEUMATIC DRUGS IN RHEUMATOID ARTHRITIS: RESULTS OF THE GO-MORE STUDY IN ROMANIA

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Romanian Journal of Rheumatology, Volume XXIV, No. 4, 2015
ISSN 1843-0791  |  e-ISSN 2069-6086
ISSN-L 1843-0791
DOI: 10.37897/RJR

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HIGHLIGHTS

National Awards “Science and Research”

NEW! RJR has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

The published medical research literature is a global public good. Medical journal editors have a social responsibility to promote global health by publishing, whenever possible, research that furthers health worldwide.

EFFICACY AND SAFETY OF GOLIMUMAB AS ADD-ON THERAPY TO DISEASE-MODIFYING ANTIRHEUMATIC DRUGS IN RHEUMATOID ARTHRITIS: RESULTS OF THE GO-MORE STUDY IN ROMANIA

Simona Rednic, Magda Parvu, Cătălin Codreanu, Ioan Ancuţa, Maria Şuţa, Anca Rosu, Rodica Chireac, Lorena Petcu and Ruxandra Ionescu

ABSTRACT

Glucocorticoids are drugs used in various medical areas, but well known for the myriad of side effects which are still a concern for the medical world. Latest recommendations on this matter aim at improving their management and implementing adequate prevention strategies. This aspect would change patient’s perspective on this treatment, reducing the fear and uncertainty associated with glucocorticoids.
Objective. Our study focuses on analysing the level of information that patients hold about glucocorticoids side effects and if the available prevention strategies are known and applied in clinical practice.
Material and methods. Study included 85 patients with rheumatic pathology and glucocorticoid therapy for at least 3 months. Study design was prospective observational and consecutive hospitalized patients were recruited, receiving and compiling a specific questionnaire.
Results. 85 patients (84.7% women, mean age 54.42 ± 16.54 years) mostly under corticotherapy due to rheumatoid arthritis (44.7%) and systemic lupus erythematosus (23.5%) were recruited. Patients with higher education had the tendency to discontinue treatment (r=0.289, p=0.007). Moreover, reading prospectus has a great influence on treatment compliance (treatment risks significantly correlated with disease duration and glucocorticoid therapy duration (r=0.232; p < 0.032, r=0.252; p <0.024 respectively). Awareness about the risk of osteoporosis correlates with reading the prospectus (r= 0.396; p <0.0001), glucocorticoid treatment duration (r=0.209; p <0.032) and the use of vitamin D supplements (r=0,315; p <0.003). Regarding glucocorticoid administration timetable, we identified two groups – early morning and late evening (44.7% vs. 55.3%), showing a non-uniform treatment schedule.
Conclusions. Our study shows an inadequate level of information regarding patient’s awareness on glucocorticoid treatment. Although excellent prevention strategies have been elaborated, there is a need of optimizing their accessibility to our patients.

Keywords: glucocorticoids, side effects, prevention strategies

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EVALUATION OF PATIENTS’ AWARENESS REGARDING GLUCOCORTICOIDS SIDE EFFECTS AND AVAILABLE PREVENTION STRATEGIES

SELECT ISSUE

Romanian Journal of Rheumatology, Volume XXIV, No. 4, 2015
ISSN 1843-0791  |  e-ISSN 2069-6086
ISSN-L 1843-0791
DOI: 10.37897/RJR

Indexed

DOI - Crossref
Similarity Check by iThenticate, worldwide No 1 professional plagiarism checking system
DOAJ
Scopus
NLM Catalog
Ebsco Host - Medline
Google Academic
Semantic Scholar

HIGHLIGHTS

National Awards “Science and Research”

NEW! RJR has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

The published medical research literature is a global public good. Medical journal editors have a social responsibility to promote global health by publishing, whenever possible, research that furthers health worldwide.

EVALUATION OF PATIENTS’ AWARENESS REGARDING GLUCOCORTICOIDS SIDE EFFECTS AND AVAILABLE PREVENTION STRATEGIES

Cristina Plăişanu, Vasilia Cristina Iorgoveanu and Ruxandra Ionescu

ABSTRACT

Glucocorticoids are drugs used in various medical areas, but well known for the myriad of side effects which are still a concern for the medical world. Latest recommendations on this matter aim at improving their management and implementing adequate prevention strategies. This aspect would change patient’s perspective on this treatment, reducing the fear and uncertainty associated with glucocorticoids.
Objective. Our study focuses on analysing the level of information that patients hold about glucocorticoids side effects and if the available prevention strategies are known and applied in clinical practice.
Material and methods. Study included 85 patients with rheumatic pathology and glucocorticoid therapy for at least 3 months. Study design was prospective observational and consecutive hospitalized patients were recruited, receiving and compiling a specific questionnaire.
Results. 85 patients (84.7% women, mean age 54.42 ± 16.54 years) mostly under corticotherapy due to rheumatoid arthritis (44.7%) and systemic lupus erythematosus (23.5%) were recruited. Patients with higher education had the tendency to discontinue treatment (r=0.289, p=0.007). Moreover, reading prospectus has a great influence on treatment compliance (treatment risks significantly correlated with disease duration and glucocorticoid therapy duration (r=0.232; p < 0.032, r=0.252; p <0.024 respectively). Awareness about the risk of osteoporosis correlates with reading the prospectus (r= 0.396; p <0.0001), glucocorticoid treatment duration (r=0.209; p <0.032) and the use of vitamin D supplements (r=0,315; p <0.003). Regarding glucocorticoid administration timetable, we identified two groups – early morning and late evening (44.7% vs. 55.3%), showing a non-uniform treatment schedule.
Conclusions. Our study shows an inadequate level of information regarding patient’s awareness on glucocorticoid treatment. Although excellent prevention strategies have been elaborated, there is a need of optimizing their accessibility to our patients.

Keywords: glucocorticoids, side effects, prevention strategies

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