[Corticosteroid-induced osteoporosis]

Corticosteroid-induced osteoporosis is the most common form of secondary osteoporosis and the first cause in young people. Bone loss occurs early after the initiation of corticosteroid therapy and is correlated to dosage and treatment duration. Osteoporosis prevention is justified in all subjects who begin glucocorticoids, since the underlying inflammation has itself a deleterious bone impact. Bone loss magnitude is variable and there is no clearly identified predictor of the individual risk of fracture. Prevention or treatment of osteoporosis should be considered in all patients who received a daily dose of at least 7.5mg equivalent prednisone and a treatment that is expected to last at least 3 months. Bisphosphonates and the anabolic agent parathyroid hormone (1-34) have shown their efficacy in the treatment of corticosteroid-induced osteoporosis. Recent international guidelines are available and should guide management of corticosteroid-induced osteoporosis that remains under-diagnosed and under-treated. Duration of anti-osteoporotic treatment should be discussed at the individual level, depending on the subject's characteristics, and on the underlying inflammation evolution.