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Glucocorticoid-induced osteoporosis: pathogenesis and management
1University of Kansas Medical Center, Kansas City.
Annals of Internal Medicine
|March 1, 1990
Summary
Glucocorticoid-induced osteoporosis affects at least 50% of patients on long-term therapy. Preventive strategies, including appropriate medication use and lifestyle, can mitigate this common complication.
Area of Science:
- Endocrinology
- Bone Metabolism
- Pharmacology
Background:
- Glucocorticoids are widely used medications with significant impact on bone health.
- Glucocorticoid-induced osteoporosis (GIOP) is a frequent and serious adverse effect of long-term glucocorticoid treatment.
Purpose of the Study:
- To comprehensively review the clinical presentation, underlying pathogenesis, and current management strategies for glucocorticoid-induced osteoporosis.
Main Methods:
- Systematic literature search of MEDLINE and bibliographies of identified articles published since 1970.
- Selection and critical appraisal of 160 relevant articles from over 200 examined.
- Discussion of the strengths and weaknesses of included studies.
Main Results:
- Glucocorticoids directly impact bone by inhibiting formation and increasing resorption.
- They reduce intestinal calcium absorption and increase renal calcium excretion.
- Osteoporosis occurs in over 50% of patients on long-term glucocorticoid therapy.
Conclusions:
- Glucocorticoid-induced osteoporosis is a prevalent complication in patients requiring long-term glucocorticoid therapy.
- Proactive preventive management is crucial to minimize the severity of this condition.