Erschienen in:
01.12.2013 | Quality of Care in Osteoporosis (SL Silverman, Section Editor)
Prevention and Treatment of Bone Changes Associated with Exposure to Glucocorticoids
verfasst von:
Amy H. Warriner, Kenneth G. Saag
Erschienen in:
Current Osteoporosis Reports
|
Ausgabe 4/2013
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Abstract
Rheumatologic diseases are associated with a proinflammatory state, which is thought to lead to many of the bone changes seen in treatment-naive patients. However, glucocorticoids remain a common treatment option for rheumatologic diseases and are known to have a negative impact on bone through direct effects on bone cells and indirect effects on calcium absorption. Despite the anti-inflammatory effect of glucocorticoids, fracture risk rises within the first 3 months of treatment. As such, osteoporosis prevention and treatment needs to be considered in all patients started on chronic glucocorticoids (≥3 months of treatment). For very low risk patients, conservative management with non-pharmacologic strategies may be appropriate. For the moderate to high fracture risk patients treated with glucocorticoids, pharmacologic treatment with 1 of the 4 approved medications should be considered. The challenge of educating physicians and patients of the risks of glucocorticoid induced osteoporosis remain.