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Osteoporosis International

Erschienen in:

25.02.2019 | Concise Clinical Review

Glucocorticoid-induced osteoporosis: 2019 concise clinical review

verfasst von: G. Adami, K. G. Saag

Erschienen in: Osteoporosis International | Ausgabe 6/2019

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Abstract

Glucocorticoids remain widely used for many medical conditions, and fractures are the most serious common adverse event related to long-term glucocorticoid use. Glucocorticoid-induced osteoporosis (GIOP) develops in a time- and dose-dependent manner, but even at low doses, an increased risk of fragility fracture may be observed even within the first month of treatment. GIOP is mediated by multiple pathophysiologic mechanisms resulting in an inhibition of bone formation and an increase in bone resorption. The clinical assessment of GIOP has potential pitfalls since dual-energy X-ray absorptiometry (DXA) may underestimate the risk of fracture in patients treated with glucocorticoids. Many national organizations have developed guidelines for assessing fracture risk and treating patients with, or at risk for, GIOP. These groups advocate both antiresorptive agents and bone-forming agents based predominately on their efficacy in improving bone mineral density. Oral bisphosphonates are generally the first-line therapy for GIOP in most patients due to their proven efficacy, good safety, and low cost. For those patients at greater risk of fracture, teriparatide should be considered earlier, based on its ability to significantly reduce vertebral fractures when compared with alendronate. GIOP remains a major public health concern that is at least partially preventable with current and potential future therapeutic options.

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Titel: Glucocorticoid-induced osteoporosis: 2019 concise clinical review
verfasst von: G. Adami
K. G. Saag
Publikationsdatum: 25.02.2019
Verlag: Springer London
Erschienen in: Osteoporosis International / Ausgabe 6/2019
Print ISSN: 0937-941X
Elektronische ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-019-04906-x

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