Review article

Glucocorticoid induced osteoporosis

Branimir Anić ; Department for Clinical Immunology and Rheumatology, Clinic for Internal Medicine of the School of Medicine, University of Zagreb, Clinical Hospital Centre Zagreb, Zagreb, Croatia
Miroslav Mayer ; Department for Clinical Immunology and Rheumatology, Clinic for Internal Medicine of the School of Medicine, University of Zagreb, Clinical Hospital Centre Zagreb, Zagreb, Croatia

Abstract

Secondary osteoporosis most often develops due to glucocorticoid therapy. Glucocorticoids affect all stages of the bone remodeling cycle, its formation and resorption. Osteoblasts are primarily affected, decreasing their activity and enhancing apoptosis. Patients treated with glucocorticoids have lower bone mineral density and increased fracture risk. Glucocorticoid-induced osteoporosis can be prevented by administering the minimal effective dose of glucocorticoids, calcium and vitamin D supplementation or, if possible, by hormone replacement therapy. Moreover, appropriate physical activity should be encouraged. Patients who are at higher risk for low-energy fractures (for example post-menopausal women) have to be actively treated, usually with antiresorptive drugs among which bisphosphonates are currently the first line therapy.

Keywords

osteoporosis; glucocorticoids; diagnostics; prevention; treatment

Hrčak ID:

137907

URI

https://hrcak.srce.hr/137907

Publication date:

23.10.2014.

Article data in other languages: croatian

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