Interní Med. 2008; 10(7): 323-326

Glucocorticoid-induced osteoporosis: emerging preventive and therapeutic options

prof. MUDr. Jan Štěpán DrSc
Revmatologický ústav, Praha

Risk of osteoporosis and fracture in patients on glucocorticoid therapy is substantially increased. Individual absolute risk to sustain a fracture within next 10 years can be assessed in clinical practice using the clinical factors according to WHO recommendation. Increased risk of fracture is due to deterioration of quality of bone resulting from suppression of new bone formation by glucocorticoids. Accordingly, a sequential bone anabolic and antiresorptive treatment is advantageous.

Keywords: Key words: glucocorticoids, osteoporosis, fracture, risk, teriparatide, aminobisphosphonates.

Published: October 1, 2008  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Štěpán J. Glucocorticoid-induced osteoporosis: emerging preventive and therapeutic options. Interní Med. 2008;10(7):323-326.
Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. Adachi JD, Bensen WG, Bell MJ, et al. Salmon calcitonin nasal spray in the prevention of corticosteroid-induced osteoporosis. Br J Rheumatol 1997; 36: 255-259. Go to original source... Go to PubMed...
    2. Buttgereit F, Straub RH, Wehling M, et al. Glucocorticoids in the treatment of rheumatic diseases: an update on the mechanisms of action. Arthritis Rheum 2004; 50: 3408-3417. Go to original source... Go to PubMed...
    3. Cooper MS, Rabbitt EH, Goddard PE, et al. Osteoblastic 11beta-hydroxysteroid dehydrogenase type 1 activity increases with age and glucocorticoid exposure. J Bone Miner Res 2002; 17: 979-986. Go to original source... Go to PubMed...
    4. Crawford BA, Liu PY, Kean MT, et al. Randomized placebo-controlled trial of androgen effects on muscle and bone in men requiring long-term systemic glucocorticoid treatment. J Clin Endocrinol Metab 2003; 88: 3167-3176. Go to original source... Go to PubMed...
    5. Dalle Carbonare L, Arlot ME, Chavassieux PM, et al. Comparison of trabecular bone microarchitecture and remodeling in glucocorticoid-induced and postmenopausal osteoporosis. J Bone Miner Res 2001; 16: 97-103. Go to original source... Go to PubMed...
    6. Dobnig H, Turner RT. Evidence that intermittent treatment with parathyroid hormone increases bone formation in adult rats by activation of bone lining cells. Endocrinology 1995; 136: 3632-3638. Go to original source... Go to PubMed...
    7. Kanis JA, Stevenson M, McCloskey EV, et al. Glucocorticoid-induced osteoporosis: a systematic review and cost-utility analysis. Health Technol Assess 2007; 11: iii-iv, ix-xi,1-231. Go to original source... Go to PubMed...
    8. Karsdal MA, Martin TJ, Bollerslev J, et al. Are nonresorbing osteoclasts sources of bone anabolic activity? J Bone Miner Res 2007; 22: 487-494. Go to original source... Go to PubMed...
    9. Kim HJ, Zhao H, Kitaura H, et al. Dexamethsone suppresses bone formation via the osteoclast. Adv Exp Med Biol 2007; 602: 43-46. Go to original source... Go to PubMed...
    10. Lems WF, Lodder MC, Lips P, et al. Positive effect of alendronate on bone mineral density and markers of bone turnover in patients with rheumatoid arthritis on chronic treatment with low-dose prednisone: a randomized, double-blind, placebo-controlled trial. Osteoporos Int 2006; 17: 716-723. Go to original source... Go to PubMed...
    11. NIH consensus development panel on osteoporosis prevention, diagnosis, and therapy. JAMA 2001; 285: 785-795. Go to PubMed...
    12. Ohnaka K, Tanabe M, Kawate H, et al. Glucocorticoid suppresses the canonical wnt signal in cultured human osteoblasts. Biochem Biophys Res Commun 2005; 329: 177-181. Go to original source... Go to PubMed...
    13. Ochi S, Shinohara M, Sato K, et al. Pathological role of osteoclast costimulation in arthritis-induced bone loss. Proc Natl Acad Sci U S A 2007; 104: 11394-11399. Go to original source... Go to PubMed...
    14. Reid DM, Hughes RA, Laan RF, et al. Efficacy and safety of daily risedronate in the treatment of corticosteroid-induced osteoporosis in men and women: a randomized trial. European Corticosteroid-Induced Osteoporosis Treatment Study. J Bone Miner Res 2000; 15: 1006-1013. Go to original source... Go to PubMed...
    15. Růžičková O, Bayer M, Pavelka K, et al. Doporučení pro prevenci a léčbu glukokortikoidy indukované osteoporózy u pacientů s revmatickým onemocněním. Osteologický Bull 2004; 9: 78-85.
    16. Saag KG, Shane E, Boonen S, et al. Teriparatide or alendronate in glucocorticoid-induced osteoporosis. N Engl J Med 2007; 357: 2028-2039. Go to original source... Go to PubMed...
    17. van Rossum EF, Lamberts SW. Polymorphisms in the glucocorticoid receptor gene and their associations with metabolic parameters and body composition. Recent Prog Horm Res 2004; 59: 333-357. Go to original source... Go to PubMed...
    18. van Staa TP, Leufkens HG, Abenhaim L, et al. Oral corticosteroids and fracture risk: relationship to daily and cumulative doses. Rheumatology (Oxford) 2000; 39: 1383-1389. Go to original source... Go to PubMed...
    19. WHO. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a WHO Study Group. Geneva: World Health Organisation, 1994.
    20. WHO Scientific Group. Assessment of osteoporosis at the primary health care level. Sheffield: University of Sheffield Medical School, UK, 2008.

    Return to the content


    Internal Medicine for Practice

    Madam, Sir,
    please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
    Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

    I declare:

    1. that I have met the above instruction
    2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited

    No
    Yes

    If your statement is not true, please be aware
    that brings the risk of danger to their health or the health of others.