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Guidelines for the prevention and treatment of glucocorticoid-induced osteoporosis in pediatrics
Oscar Brunetto1, Hamilton R Cassinelli2, Graciela Espada3
1Department of Endocrinology, Hospital General de Niños Pedro de Elizalde, City of Buenos Aires, Argentina.
Insights
This study offers guidelines for managing pediatric patients on glucocorticoid (GC) therapy, focusing on preventing and treating GC-induced osteoporosis. It provides actionable recommendations for healthcare professionals to ensure optimal bone health in children.
Area of Science:
- Pediatric Endocrinology
- Bone Metabolism
- Pharmacology
Background:
- Glucocorticoid (GC) therapy is essential for various pediatric conditions.
- Long-term GC use is associated with significant risks, including osteoporosis.
- Managing GC-induced osteoporosis in children requires specialized guidance.
Purpose of the Study:
- To establish a framework for healthcare professionals managing pediatric patients on GC therapy.
- To develop evidence-based recommendations for preventing and treating GC-induced osteoporosis in pediatric populations.
Main Methods:
- A panel of pediatric bone and disease experts convened to formulate PICO questions.
- A systematic literature review was conducted following the GRADE approach.
- Evidence quality was classified, and recommendations were formulated via expert consensus and voting.
Main Results:
- Seven specific recommendations for GC-induced osteoporosis management were developed.
- Six overarching principles for pediatric GC-induced osteoporosis were established.
- The findings provide a comprehensive approach to bone health in children on GC therapy.
Conclusions:
- The developed recommendations offer crucial guidance for clinicians treating pediatric patients with GC therapy.
- This framework aims to mitigate the risk of osteoporosis in children undergoing long-term GC treatment.
- Effective management strategies are vital for improving outcomes in this vulnerable population.
Abstract:
Objective. To provide a framework for healthcare professionals managing pediatric patients who are on active glucocorticoid (GC) therapy and to develop recommendations for the prevention and treatment of GC-induced osteoporosis in the pediatric population. Methods. A panel of experts on bone and pediatric diseases developed a series of PICO questions that address issues related to the prevention and treatment of osteoporosis in patients on GC therapy. In accordance with the GRADE approach, we conducted a systematic review of the literature, summarized effect estimations, and classified the quality of the evidence. Then, voting and the formulation of recommendations followed. Results. Seven recommendations and six general principles were developed for GC-induced osteoporosis in the pediatric population. Conclusion. These recommendations provide guidance for clinicians who must make decisions concerning pediatric patients undergoing treatment with GC.
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