Glucocorticoid-induced osteoporosis in men

Area of Science:

• Endocrinology
• Rheumatology
• Bone Metabolism

Background:

• Glucocorticoid therapy commonly leads to osteoporosis and fractures.
• Men with glucocorticoid-induced osteoporosis (GIOP) are often overlooked despite specific risk factors like COPD and organ transplantation.
• Despite lower general osteoporosis risk, men require attention for GIOP.

Purpose of the Study:

• To highlight the under-recognition of GIOP in men.
• To review the evaluation and treatment options for GIOP in men.
• To emphasize the importance of identifying men at risk for GIOP.

Main Methods:

• Review of existing literature on GIOP in men and women.
• Analysis of Food and Drug Administration (FDA)-approved treatments for GIOP.
• Comparison of teriparatide and alendronate efficacy in a clinical trial.

Main Results:

• Men face unique reasons for oral glucocorticoid use, increasing GIOP risk.
• FDA-approved treatments including bisphosphonates (alendronate, risedronate, zoledronic acid) and teriparatide are available for GIOP in men.
• Teriparatide demonstrated superior bone density increase and reduced vertebral fractures compared to alendronate in a trial.

Conclusions:

• Effective management strategies for GIOP exist for both men and women.
• The primary barrier to improving outcomes for men with GIOP is insufficient recognition of risk.
• Proactive identification of at-risk men is paramount for preventing fractures and improving bone health outcomes.