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08:02
Fecal Glucocorticoid Analysis: Non-invasive Adrenal Monitoring in Equids
Published on: April 25, 2016
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Bone and glucocorticoids
1Rheumatology department, Cochin Hospital, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France.
Annales D'Endocrinologie
|April 25, 2018
Summary
Corticosteroid-induced osteoporosis is a common secondary form, increasing fracture risk with dose and duration. Prevention and treatment with bisphosphonates or teriparatide are crucial, though management remains inadequate.
Area of Science:
- Endocrinology
- Rheumatology
- Orthopedics
Background:
- Corticosteroid-induced osteoporosis (CIOP) is the leading cause of secondary osteoporosis and a frequent cause in younger populations.
- Bone loss and fracture risk escalate rapidly with corticosteroid initiation, dose, and duration.
- Fracture risk in CIOP is influenced by bone mineral density, bone quality, and fall risk.
Purpose of the Study:
- To review the pathophysiology, risk factors, and management strategies for corticosteroid-induced osteoporosis.
- To highlight the inadequacy of current management despite available guidelines.
- To emphasize the need for individualized treatment duration based on patient factors and inflammation.
Main Methods:
- Literature review of corticosteroid-induced osteoporosis.
- Analysis of risk factors including dose, duration, bone quality, and falls.
- Evaluation of current treatment options and guidelines.
Main Results:
- Fracture risk is not solely predicted by bone mineral density.
- Bone quality is impaired by both corticosteroids and underlying inflammation.
- Bisphosphonates and teriparatide demonstrate efficacy in treating CIOP.
Conclusions:
- CIOP requires proactive prevention and management in all patients starting corticosteroid therapy.
- Current management of CIOP is suboptimal.
- Treatment duration for CIOP should be individualized, considering patient characteristics and disease progression.
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