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Update on Glucocorticoid Induced Osteoporosis
Soo-Kyung Cho1, Yoon-Kyoung Sung1
1Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea.
Endocrinology and Metabolism (Seoul, Korea)
|June 10, 2021
Summary
Glucocorticoids can cause bone loss and increase fracture risk, leading to glucocorticoid-induced osteoporosis. Early assessment and treatments like bisphosphonates are crucial for prevention.
Area of Science:
- Endocrinology
- Bone Metabolism
- Rheumatology
Background:
- Glucocorticoids are widely used for autoimmune and inflammatory conditions.
- A significant adverse effect is bone damage, potentially causing glucocorticoid-induced osteoporosis.
- This condition involves increased bone resorption and fracture risk, especially within 3 months of oral glucocorticoid use.
Purpose of the Study:
- To provide an updated overview of glucocorticoid-induced osteoporosis.
- To focus on risk assessment strategies for patients on glucocorticoids.
- To review current and emerging treatment options for this condition.
Main Methods:
- Review of recent practice guidelines for fracture risk assessment.
- Analysis of recommended fracture risk assessment tools.
- Evaluation of current therapeutic agents for glucocorticoid-induced osteoporosis.
Main Results:
- Guidelines recommend fracture risk assessment for patients on glucocorticoids for over 3 months.
- Bisphosphonates are the first-line therapy, improving bone mineral density and reducing vertebral fractures.
- Denosumab shows increased bone density, while teriparatide prevents vertebral fractures.
Conclusions:
- Early risk assessment and intervention are vital for preventing fractures in patients using glucocorticoids.
- Bisphosphonates remain the primary treatment for glucocorticoid-induced osteoporosis.
- Newer agents like denosumab offer alternative therapeutic strategies.
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