[Prevention and treatment of corticosteroid-induced osteoporosis]

Osteoporosis and fractures are frequent and severe consequences of long-term treatment with glucocorticoids. Trabecular bone is mainly affected with a decrease of bone formation and an increase of bone resorption. Prevention and treatment of corticosteroid-induced osteoporosis is based upon general measures such as calcium and vitamin D supplementation, adequate+ protein intake, regular physical exercise, hormonal replacement therapy and upon specific means like therapies used in primary osteoporosis. Bisphosphonates which are potent bone resorption inhibitors have been shown to increase bone mineral density and to decrease fracture rate. Therefore they appear as first choice in the prevention as well as in the treatment of corticosteroid-induced osteoporosis.