Prevention and treatment of glucocorticoid-induced osteoporosis.

Academic Article

Abstract

  • Glucocorticoids continue to be used for many inflammatory diseases, and glucocorticoid-induced osteoporosis (GIOP) remains the most common secondary form of metabolic bone disease. Recent meta-analyses suggest that both active and native vitamin D can help maintain lumbar spine bone mineral density (BMD), particularly in patients receiving lower-dose glucocorticoid therapy. Recent randomized, controlled clinical trials have shown that oral bisphosphonates are superior to vitamin D in maintaining BMD and should be continued for as long as a person receives glucocorticoid treatment. Similar to the oral bisphosphonates, intravenous ibandronate has been shown to preserve BMD and also to significantly reduce vertebral fracture risk. Increasing evidence supports a role for parathyroid hormone to prevent or treat GIOP as well. Despite effective therapies, many at-risk patients fail to receive treatment for GIOP, and even among those who initiate treatment, half discontinue within 1 to 2 years. New approaches to evidence implementation are being tested to improve the quality of osteoporosis care and decrease fracture risk among long-term glucocorticoid users.
  • Published In

    Keywords

  • Alendronate, Bone Density Conservation Agents, Calcium, Cost-Benefit Analysis, Diphosphonates, Etidronic Acid, Female, Glucocorticoids, Humans, Ibandronic Acid, Male, Osteoporosis, Parathyroid Hormone, Patient Compliance, Practice Guidelines as Topic, Quality of Health Care, Rheumatic Diseases, Time Factors, Vitamin D, Vitamin K
  • Pubmed Id

  • 19272549
  • Author List

  • Curtis JR; Saag KG
  • Start Page

  • 14
  • End Page

  • 21
  • Volume

  • 5
  • Issue

  • 1