Osteoporosis after long-term corticosteroid treatment of giant cell arteritis

The mineral content of the heel bone, and signs of osteoporosis on X-ray of the spine, were evaluated in 26 patients (20 women and 6 men) with giant cell arteritis (GCA), treated with prednisolone for an average period of 5 years. The mean age was 78 years (range 66-95 years). These results were compared with those obtained from a large population study of individuals aged 72, 75, 82 and 85 years. An increase of obvious and severe spinal osteoporosis from 16 to 85% was observed in the women in the population study between the ages of 72 and 85. No additional osteoporosis that could be attributed to the cortisone treatment was found among the GCA patients. The bone mineral content was not reduced in the patients compared to the general population. We conclude that there is no justification for attempting non-steroid treatment in GCA on account of the risk of osteoporosis. Corticosteroids are the only safe treatment for prevention of complications of GCA.