INFO - Steroid-induced bone loss and fractures

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Prev Med. 2003 Feb;36(2):243-9.

Glucocorticoid-induced osteoporosis: pathogenesis, diagnosis, and

management.

McIlwain HH.

Tampa Medical Group Research, 4700 N. Habana Avenue, Suite 303, Tampa, FL

33614, USA. hmcil@...

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.

PMID: 12591000

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=pubmed & dopt=Abstra\

ct & list_uids=12591000 & itool=iconabstr

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Mayo Clinic in Rochester

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s Hopkins Medicine

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