Glucocorticoid-induced osteoporosis: how best to avoid fractures.

Glucocorticoids are one of the most commonly prescribed medications and are used to treat a wide range of chronic inflammatory diseases. The main limitation of this therapy is the development of osteoporosis and bone fractures. Recent studies have given us insight into the epidemiology of glucocorticoid-induced fractures demonstrating both the magnitude of the problem and the types of patients who are likely to be most at risk. Additionally, several randomised trials have demonstrated beneficial effects of bone targeted medications in the setting of glucocorticoid-induced osteoporosis. This article will review these recent findings, will suggest when patients are likely to be at a significant risk of fracture and discuss how best to reduce this risk.