Emory Hsu1, Mark Nanes. 1. Emory University School of Medicine, Atlanta, Georgia, USA.
Abstract
PURPOSE OF REVIEW: The aim of this study is to summarize monitoring, prevention and treatment options of glucocorticoid-induced osteoporosis for patients on chronic glucocorticoid therapy. RECENT FINDINGS: Recent meta-analyses highlight the efficacy of bisphosphonate use in improving bone mineral density and in reducing vertebral fractures in the setting of long-term glucocorticoid use. A new study has now shown that alendronate also reduces the risk of hip fracture in glucocorticoid use. Emerging data indicate that teriparatide and denosumab also reduce the risk of osteoporotic fracture in glucocorticoid-induced osteoporosis. SUMMARY: Glucocorticoid use is a leading cause of secondary osteoporosis; however, patients at risk of glucocorticoid-induced osteoporosis are often not evaluated or treated in a timely manner. Patients on a dose equivalent of 2.5 mg prednisone or greater for 3 months or longer duration should have their fracture risk assessed. Those at moderate or high risk should start bisphosphonate therapy, or if contraindicated, a second-line agent such as teriparatide or denosumab.
PURPOSE OF REVIEW: The aim of this study is to summarize monitoring, prevention and treatment options of glucocorticoid-induced osteoporosis for patients on chronic glucocorticoid therapy. RECENT FINDINGS: Recent meta-analyses highlight the efficacy of bisphosphonate use in improving bone mineral density and in reducing vertebral fractures in the setting of long-term glucocorticoid use. A new study has now shown that alendronate also reduces the risk of hip fracture in glucocorticoid use. Emerging data indicate that teriparatide and denosumab also reduce the risk of osteoporotic fracture in glucocorticoid-induced osteoporosis. SUMMARY: Glucocorticoid use is a leading cause of secondary osteoporosis; however, patients at risk of glucocorticoid-induced osteoporosis are often not evaluated or treated in a timely manner. Patients on a dose equivalent of 2.5 mg prednisone or greater for 3 months or longer duration should have their fracture risk assessed. Those at moderate or high risk should start bisphosphonate therapy, or if contraindicated, a second-line agent such as teriparatide or denosumab.
Authors: Saskia E Zieck; Johnson George; Brooke A Blakeley; Liam Welsh; Simon James; Sarath Ranganathan; Peter Simm; Angelina Lim Journal: J Paediatr Child Health Date: 2017-06-01 Impact factor: 1.954
Authors: Robin K Dore; Stanley B Cohen; Nancy E Lane; William Palmer; William Shergy; Lifen Zhou; Huei Wang; Wayne Tsuji; Richard Newmark Journal: Ann Rheum Dis Date: 2009-09-03 Impact factor: 19.103
Authors: Jau-Yi Li; Benoit Chassaing; Abdul Malik Tyagi; Chiara Vaccaro; Tao Luo; Jonathan Adams; Trevor M Darby; M Neale Weitzmann; Jennifer G Mulle; Andrew T Gewirtz; Rheinallt M Jones; Roberto Pacifici Journal: J Clin Invest Date: 2016-04-25 Impact factor: 14.808
Authors: Lorin B Sher; Henning W Woitge; Douglas J Adams; Gloria A Gronowicz; Zygmunt Krozowski; John R Harrison; Barbara E Kream Journal: Endocrinology Date: 2003-11-14 Impact factor: 4.736