Management of glucocorticoid-induced osteoporosis

Long-term glucocorticoid (GC) therapy is frequently indicated to treat autoimmune and chronic inflammatory diseases in daily clinical practice. Two of the most devastating untoward effects are bone loss and fractures. Doses as low as 2.5 mg of prednisone for more than 3 months can impair bone integr...

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Veröffentlicht in:Aging clinical and experimental research 2021-04, Vol.33 (4), p.793-804
Hauptverfasser: Messina, Osvaldo D., Vidal, Luis Fernando, Wilman, Maritza Vidal, Bultink, Irene E. M., Raterman, Hennie G., Lems, William
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container_issue 4
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container_title Aging clinical and experimental research
container_volume 33
creator Messina, Osvaldo D.
Vidal, Luis Fernando
Wilman, Maritza Vidal
Bultink, Irene E. M.
Raterman, Hennie G.
Lems, William
description Long-term glucocorticoid (GC) therapy is frequently indicated to treat autoimmune and chronic inflammatory diseases in daily clinical practice. Two of the most devastating untoward effects are bone loss and fractures. Doses as low as 2.5 mg of prednisone for more than 3 months can impair bone integrity. Population at risk is defined based on the dose and duration of GC therapy and should be stratified according to FRAX (Fracture Risk Assessment Tool), major osteoporotic fracture, prior fractures, and bone mineral density values (BMD). General measures include to prescribe the lowest dose of GC to control the underlying disease for the shortest possible time, maintain adequate vitamin D levels and calcium intake, maintain mobility, and prescribe a bone acting agent in patients at high risk of fracture. These agents include oral and intravenous bisphosphonates, denosumab, and teriparatide.
doi_str_mv 10.1007/s40520-021-01823-0
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subjects Apoptosis
Arthritis
Bone Density
Bone Density Conservation Agents - adverse effects
Clinical medicine
Disease
Drug dosages
Fractures
Geriatrics/Gerontology
Glucocorticoids - adverse effects
Health risks
Humans
Medicine
Medicine & Public Health
Osteoporosis
Osteoporosis - chemically induced
Osteoporosis - drug therapy
Osteoporotic Fractures - chemically induced
Osteoporotic Fractures - prevention & control
Pathogenesis
Review
Rheumatology
Womens health
title Management of glucocorticoid-induced osteoporosis
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