Glucocorticoid-induced osteoporosis: pathogenesis, diagnosis, and management.

Abstract:

:Glucocorticoid-induced bone loss is dose- and duration-related, develops rapidly (within months of therapy), and leads to an increased risk of fractures. Moreover, less than one in four patients prescribed oral glucocorticoids receive any treatment to prevent or treat osteoporosis. The American College of Rheumatology recommends bisphosphonate therapy to prevent bone loss in most patients beginning long-term glucocorticoid therapy (prednisone equivalent of > or =5 mg/day for at least 3 months), and in men and postmenopausal women receiving long-term glucocorticoids who have an abnormal bone mineral density (T score below -1). Patients with glucocorticoid-induced osteoporosis are at particularly high risk for fractures, and should be treated aggressively to reduce fracture risk. Risedronate is approved in the United States for both prevention and treatment of glucocorticoid-induced osteoporosis and alendronate is approved for treatment. Both drugs increase bone mass in patients with established glucocorticoid-induced osteoporosis. Risedronate has been shown to significantly reduce the incidence of fractures after 1 year of treatment. Prevention or treatment of glucocorticoid-induced bone loss is recommended for patients at risk.

journal_name

Prev Med

journal_title

Preventive medicine

authors

McIlwain HH

doi

10.1016/s0091-7435(02)00019-1

subject

Has Abstract

pub_date

2003-02-01 00:00:00

pages

243-9

issue

2

eissn

0091-7435

issn

1096-0260

pii

S0091743502000191

journal_volume

36

pub_type

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