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Glucocorticoid-induced osteoporosis.

Karine Briot1, Christian Roux1

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RMD Open
|October 29, 2015
PubMed
Summary

Corticosteroid-induced osteoporosis is a common secondary cause of bone loss, especially in young individuals. Early intervention with bisphosphonates or parathyroid hormone is recommended for prevention and treatment.

Keywords:
CytokinesInflammationOsteoporosisRheumatoid Arthritis

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Area of Science:

  • Endocrinology
  • Rheumatology
  • Bone Metabolism

Background:

  • Corticosteroid-induced osteoporosis (CIOP) is the most prevalent secondary osteoporosis and a leading cause in younger populations.
  • Bone loss and fracture risk escalate early with corticosteroid therapy, influenced by dosage and duration.
  • Fracture risk assessment in CIOP extends beyond bone mineral density, encompassing bone quality and fall risk.

Purpose of the Study:

  • To review the pathophysiology, risk factors, and management strategies for corticosteroid-induced osteoporosis.
  • To emphasize the importance of early prevention and treatment in patients receiving corticosteroids, particularly those with rheumatoid arthritis.
  • To highlight the role of international guidelines in addressing the under-diagnosis and under-treatment of CIOP.

Main Methods:

  • Literature review of existing studies and international guidelines on corticosteroid-induced osteoporosis.
  • Analysis of factors contributing to bone loss and fracture risk in patients on corticosteroid therapy.
  • Evaluation of therapeutic options including bisphosphonates and parathyroid hormone (1-34).

Main Results:

  • Corticosteroid therapy significantly increases bone loss and fracture rates, even at low doses in conditions like rheumatoid arthritis.
  • Bone mineral density alone is insufficient for comprehensive fracture risk evaluation in CIOP.
  • Bisphosphonates and parathyroid hormone (1-34) demonstrate efficacy in treating CIOP.

Conclusions:

  • All patients on prednisone require consideration for osteoporosis prevention or treatment.
  • Management should be guided by recent international guidelines to combat under-diagnosis and under-treatment.
  • The duration of antiosteoporotic therapy should be individualized based on patient characteristics and underlying inflammatory conditions.