PO94 - Steroid stewardship in cardiac sarcoidosis: bone health monitoring and prevention in a tertiary cardiac sarcoid cohort
Dhruv Thakur (UK)1; Juan Carlos Quijano-Campos (UK)2 3 4; Fiona Kearl (UK)3; Marina Zaromytidou (UK)3; Gavin Thomas (UK)5; Neha Sekhri (UK)3 4; Richard Toshner (UK)5;
1 - Leicester Medical School, University of Leicester, Leicester; 2 - Faculty of Nursing, Midwifery & Palliative Care, King’s College London, London; 3 - Department of Inherited Cardiac Conditions, Barts Heart Centre, St. Bartholomew’s Hospital, London; 4 - William Harvey Research Institute, Queen Mary University of London, London; 5 - Department of Respiratory Medicine, St. Bartholomew’s Hospital, London;
Keywords: Cardiac-involvement; Monitoring; Prevention;
Select the theme: Cardiac Sarcoidosis
Type: Original Papers
Presentation: Poster Presentation

Introduction: Oral corticosteroids remain a cornerstone in the management of cardiac sarcoidosis (CS), however the optimal duration of the therapy remains controversial. Despite associated adverse effects, including reduced bone mineral density and increased fracture risk. Recent WASOG task force has emphasised the importance of steroid stewardship, to minimise exposure and proactively monitor toxicity. However, real-world data on bone health assessment and preventative strategies in CS remain limited.

Objectives: To audit bone health monitoring and preventative strategies in patients with cardiac sarcoidosis receiving long-term corticosteroid therapy (≥3 months) in a real-world tertiary cohort.

Materials and Methods: A retrospective audit of consecutive patients with CS managed at a UK tertiary centre (2014 -2025).

Data collected included corticosteroid exposure for over 3-months, bone health monitoring (dual-energy X-ray absorptiometry, DEXA), and preventative strategies, including bisphosphonates and calcium/vitamin D supplementation. Bone mineral density outcomes were recorded where available.

Descriptive analyses were performed to evaluate patterns of care and alignment with emerging stewardship principles.

Results: We identified 64 CS patients of whom 63%(n=40) were currently on steroids alongside steroid sparing agents (methotrexate n=21, azathioprine n=11, mycophenolate n=8). The mean age of the cohort was 55 years, with 39% of patients aged ≥60 years.

DEXA scan had been performed in 38%(n=24) of the cohort, while 62%(n=40) had no documented bone density assessment at any time. Among those assessed, osteopenia was identified in 38% and osteoporosis in 4%.

Preventative strategies were variably implemented. Bisphosphonates were prescribed in 66%(n=42) of the whole cohort and of those on current steroid, only 57%(n=23) of patients were on bisphosphonates. 18% were on calcium/vitamin D supplementation.

Conclusions: Despite substantial corticosteroid exposure, implementation of bone health monitoring and preventative strategies remained inconsistent. These findings highlight the need for clinician awareness and for a structured approach to address steroid-related bone toxicity and aligns with current WASOG priorities in steroid stewardship.