Management of glucocorticoid induced osteoporosis in premenopausal women with autoimmune disease.

Abstract:

:Numerous inflammatory rheumatic diseases occurring in premenopausal women require the use of high doses of glucocorticoids (GC). It was believed for many years that premenopausal women were, at least to some extent, protected from bone loss associated with GC therapy. However, epidemiological studies performed in premenopausal women with systemic lupus erythematosus, demonstrate that these patients have lower bone mineral density as compared to age-matched controls. This is explained in part by the underlying disease and in part by treatment with GC. The American College of Rheumatology recommends life style adaptation, supplementation with calcium and vitamin D in patients receiving, or initiating therapy with >/=5 mg equivalent prednisone/day. Bisphosphonates are recommended, but they should be used with caution in young women as they cross the placenta and can affect skeletal remodeling in the foetus. Bisphosphonates have a prolonged terminal half-life and data on their safety extends to 10 years. It is therefore critical to inform premenopausal women about the risks of bisphosphonates and to recommend bisphosphonates with shorter terminal half-life.

journal_name

Autoimmun Rev

journal_title

Autoimmunity reviews

authors

Franchimont N,Canalis E

doi

10.1016/s1568-9972(03)00056-9

keywords:

subject

Has Abstract

pub_date

2003-06-01 00:00:00

pages

224-8

issue

4

eissn

1568-9972

issn

1873-0183

pii

S1568997203000569

journal_volume

2

pub_type

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