Prevention and treatment of bone changes associated with exposure to glucocorticoids.

Academic Article

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.
  • Published In

    Keywords

  • Bone Density, Bone and Bones, Calcium, Diphosphonates, Fractures, Bone, Glucocorticoids, Humans, Osteoporosis, Rheumatic Diseases, Risk Factors, Vitamin D
  • Digital Object Identifier (doi)

    Author List

  • Warriner AH; Saag KG
  • Start Page

  • 341
  • End Page

  • 347
  • Volume

  • 11
  • Issue

  • 4