Panacea Index Logo

Command Palette

Search for a command to run...

Glucocorticoid-induced osteoporosis: who to treat with what agent?

Nature reviews. Rheumatology
February 1, 2015
René Rizzoli et al. (2 authors)
Journal ArticleReviewHuman Study
Extracted Claims (3)
InterventionDirectionEndpointPopulationDosageImpactClaim #
anti-resorptives including bisphosphonates
no change
management of glucocorticoid-induced osteoporosis
patients with glucocorticoid-induced osteoporosis
-
are effective
#1
bone anabolic agent teriparatide
no change
management of glucocorticoid-induced osteoporosis
patients with glucocorticoid-induced osteoporosis
-
are effective
#2
calcium and vitamin D supplementation
no change
prevention of glucocorticoid-induced osteoporosis
patients receiving or initiating glucocorticoid therapy
-
is less effective
#3
Abstract

Among the adverse events of glucocorticoid treatment are bone loss and fractures. Despite available, effective preventive measures, many patients receiving or initiating glucocorticoid therapy are not appropriately evaluated and treated for bone health and fracture risk. Populations with, or at risk of, glucocorticoid-induced osteoporosis (GIOP) to target for these measures are defined on the basis of dose and duration of glucocorticoid therapy and bone mineral density. That patients with GIOP should be treated as early as possible is generally agreed upon; however, diversity remains in intervention thresholds and management guidelines. The FRAX(®) algorithm provides a 10-year probability of fracture that can be adjusted according to glucocorticoid dose. There is no evidence that GIOP and postmenopausal osteoporosis respond differently to treatments. Available anti-osteoporotic therapies such as anti-resorptives including bisphosphonates and the bone anabolic agent teriparatide are effective for the management of GIOP. Prevention with calcium and vitamin D supplementation is less effective than specific anti-osteoporotic treatment. Anti-osteoporotic treatment should be stopped at the time of glucocorticoid cessation, unless the patient remains at increased risk of fracture.

Medical Subject Headings (MeSH)
Bone DevelopmentBone and BonesCalciumDiphosphonatesGlucocorticoidsHumansIntestinal AbsorptionOsteoporosisOsteoporotic FracturesPatient SelectionVitamins
Study Links
Citation Metrics
Total Citations124
Citations/Year12.4
Relative Citation Ratio4.82
NIH Percentile92.6%
Research Impact Scores
APT Score0.95
Related Supplements