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Management of glucocorticoid-induced osteoporosis

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A Correction to this article was published on 23 July 2021

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Abstract

Long-term glucocorticoid (GC) therapy is frequently indicated to treat autoimmune and chronic inflammatory diseases in daily clinical practice. Two of the most devastating untoward effects are bone loss and fractures. Doses as low as 2.5 mg of prednisone for more than 3 months can impair bone integrity. Population at risk is defined based on the dose and duration of GC therapy and should be stratified according to FRAX (Fracture Risk Assessment Tool), major osteoporotic fracture, prior fractures, and bone mineral density values (BMD). General measures include to prescribe the lowest dose of GC to control the underlying disease for the shortest possible time, maintain adequate vitamin D levels and calcium intake, maintain mobility, and prescribe a bone acting agent in patients at high risk of fracture. These agents include oral and intravenous bisphosphonates, denosumab, and teriparatide.

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Authors and Affiliations

  1. Investigaciones Reumatológicas y Osteológicas (IRO) Medical Center, Buenos Aires, Argentina

    Osvaldo D. Messina

  2. Centro de Diagnóstico de Osteoporosis y Enfermedades Reumáticas (CEDOR), Lima, Perú

    Luis Fernando Vidal & Maritza Vidal Wilman

  3. Department of Rheumatology, Amsterdam UMC, Amsterdam Rheumatology and Immunology Center, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands

    Irene E. M. Bultink

  4. Department of Rheumatology, North West Clinics, Postbus 501, 1800 AM, Alkmaar, The Netherlands

    Hennie G. Raterman

  5. Department of Rheumatology, Amsterdam UMC, Location VU University Medical Centre Amsterdam, Amsterdam, Noord-Holland, The Netherlands

    William Lems

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  1. Osvaldo D. Messina
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  2. Luis Fernando Vidal
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  6. William Lems
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Correspondence to Maritza Vidal Wilman.

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Messina, O.D., Vidal, L.F., Wilman, M.V. et al. Management of glucocorticoid-induced osteoporosis. Aging Clin Exp Res 33, 793–804 (2021). https://doi.org/10.1007/s40520-021-01823-0

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