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[Glucocorticoid induced osteoporosis].

Branimir Anić, Miroslav Mayer

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    PubMed
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    Glucocorticoid therapy commonly causes secondary osteoporosis by impairing bone formation and increasing resorption. Prevention and treatment involve minimizing glucocorticoid dosage, supplementation, and bisphosphonate therapy for high-risk patients.

    Area of Science:

    • Endocrinology
    • Bone Biology
    • Pharmacology

    Context:

    • Secondary osteoporosis is a significant complication of glucocorticoid therapy.
    • Glucocorticoids disrupt the delicate balance of bone remodeling, affecting both formation and resorption processes.
    • Osteoblast dysfunction and apoptosis are key mechanisms leading to bone loss.

    Purpose:

    • To elucidate the mechanisms by which glucocorticoids induce osteoporosis.
    • To outline strategies for preventing and managing glucocorticoid-induced bone loss.
    • To highlight current therapeutic approaches for patients at high fracture risk.

    Summary:

    • Glucocorticoid therapy adversely impacts bone remodeling by decreasing osteoblast activity and promoting apoptosis, leading to reduced bone mineral density and increased fracture risk.

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  • Preventive measures include using the lowest effective glucocorticoid dose, calcium and vitamin D supplementation, and hormone replacement therapy.
  • Physical activity is encouraged, and antiresorptive drugs, particularly bisphosphonates, are the first-line treatment for high-risk individuals.
  • Impact:

    • Provides a comprehensive overview of glucocorticoid-induced osteoporosis, aiding clinicians in patient management.
    • Emphasizes the importance of proactive prevention and early intervention strategies.
    • Informs therapeutic decisions, guiding the use of bisphosphonates as a primary treatment for at-risk populations.