Vnitr Lek 2009, 55(5):506-511

Glucocorticoid-induced osteoporosis treatment algorithm

J. Payer*, Z. Killinger, K. Brázdilová
V. interná klinika Lekárskej fakulty UK a FNsP Bratislava, Slovenská republika, prednosta prof. MUDr. Juraj Payer, CSc.

An excess amount of glucocorticoids represents the primary and most frequent etiological factor influencing secondary osteoporosis. The patients receiving glucocorticoids, but also those with the endogenous form of hypercorticism are at high risk for the loss of bone density, with the subsequent occurrence of pathological fractures. In this review, we summarize the currently available methods of prevention and the treatment of glucocorticoid-induced osteoporosis (GIO). We also include a proposal for both prophylactic and therapeutic approach that takes into account the risk factors typical for long-term users of glucocorticoids.

Keywords: glucocorticoid-induced osteoporosis; bone density; osteoporotic fractures; calcium and vitamin D; bisphosphonates; teriparatide

Received: November 18, 2008; Accepted: January 13, 2009; Published: May 1, 2009  Show citation

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Payer J, Killinger Z, Brázdilová K. Glucocorticoid-induced osteoporosis treatment algorithm. Vnitr Lek. 2009;55(5):506-511.
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    References

    1. Payer J, Killinger Z. Kostné zmeny pri hyperkorticizme. Rheumatol 1999; 13: 181-183.
    2. Van Staa TP, Leufkens HG, Cooper C. The epidemiology of corticosteroid-induced osteoporosis: a meta-analysis. Osteoporos Int 2002; 13: 777-787. Go to original source... Go to PubMed...
    3. Zikán V. Glukokortikoidy a osteoporóza. Vnitř Lék 2007; 53: 831-840. Go to PubMed...
    4. Van Staa TP, Leufkens HGM, Abenhaim L et al. Oral corticosteroids and fracture risk: relationship to daily and cumulative doses. Rheumatol 2000; 39: 1383-1389. Go to original source... Go to PubMed...
    5. Van Staa T, Leufkens HGM, Abenhaim L et al. Use of oral corticosteroids and risk of fractures. J Bone Miner Res 2000; 15: 993-1000. Go to original source... Go to PubMed...
    6. De Gregório LH, Lacativa PG, Melazzi AC et al. Glucocorticoid-induced osteoporosis. Arq Bras Endocrinol Metabol 2006; 50: 793-801. Go to original source... Go to PubMed...
    7. Van Staa TP. The pathogenesis, epidemiology and management of glucocorticoid-induced osteoporosis. Calcif Tissue Int 2006; 79: 129-137. Go to original source... Go to PubMed...
    8. Kanis JA, Johnell O, Oden A et al. FRAX and the assessment of fracture probability in men and women from the UK. Osteoporos Int 2008; 19: 385-397. Go to original source... Go to PubMed...
    9. Payer J, Rovenský J, Killinger Z. Lexikón osteoporózy. SAP 2007; 30.
    10. Alesci S, De Martino MU, Ilias I et al. Glucocorticoid-Induced Osteoporosis: From Basic Mechanisms to Clinical Aspects. Neuroimmunomodulation 2005; 12: 1-19. Go to original source... Go to PubMed...
    11. Aagaard EM, Lin P, Modin GW et al. Prevention of glucocorticoid-induced osteoporosis: provider practice at an urban county hospital. Am J Med 1999; 107: 456-460. Go to original source... Go to PubMed...
    12. Lee YH, Lim YW, Ling PS et al. Inadequate dietary calcium intake in elderly patients with hip fractures. Singapore Med J 2007; 48: 1117-1121. Go to PubMed...
    13. Štěpán J. Účinnost antiresorpční léčby postmenopauzální osteoporózy. Vnitř Lék 2007; 53: 293-299. Go to PubMed...
    14. Lems WF, Van Veen GJ, Gerrits MI et al. Effect of low-dose prednisone (with calcium and calcitriol supplementation) on calcium and bone metabolism in healthy volunteers. Br J Rheumatol 1998; 37: 27-33. Go to original source... Go to PubMed...
    15. Sambrook P, Birmingham J, Kelly P et al. Prevention of corticosteroid osteoporosis. A comparison of calcium, calcitriol, and calcitonin. N Engl J Med 1993; 328: 1747-1752. Go to original source... Go to PubMed...
    16. Richy F, Ethgen O, Bruyere O et al. Efficacy of alphacalcidol and calcitriol in primary and corticosteroid-induced osteoporosis: a meta-analysis of their effects on bone mineral density and fracture rate. Ost Int 2004; 14: 301-310. Go to original source... Go to PubMed...
    17. Mok CC, Tong KH, To CH et al. Risedronate for prevention of bone mineral density loss in patients receiving high-dose glucocorticoids: a randomized double-blind placebo-controlled trial. Ost Int 2008; 19: 357-364. Go to original source... Go to PubMed...
    18. Ringe JD, Dorst A, Faber H et al. Intermittent intravenous ibandronate injections reduce vertebral fracture risk in corticosteroid-induced osteoporosis: results from a long-term comparative study. Ost Int 2003; 14: 801-807. Go to original source... Go to PubMed...
    19. 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...
    20. Cruse LM, Valeriano J, Vasey FB et al. Prevalence of evaluation and treatment of glucocorticoid-induced osteoporosis in men. J Clin Rheumatol 2006; 12: 221-225. Go to original source... Go to PubMed...
    21. Yamada H. Long-term effect of 1 alpha-hydroxyvitamin D, calcium and thiazide administration on glucocorticoid-induced osteoporosis. Nippon Naibunpi Gakkai Zasshi 1989; 65: 603-14. Go to original source... Go to PubMed...
    22. Štěpán J. Osteoporóza v praxi. Praha: Triton 1997; 156.
    23. 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...
    24. Štěpán J. Glukokortikoidy indukovaná osteoporóza: Nové možnosti prevence a léčby. Interní Med 2008; 10: 323-326.
    25. Čierny D, Killinger Z, Payer J. Postavenie teriparatidu a intaktného parathormónu v liečbe osteoporózy. Slov Lek 2007; 17: 226-230.
    26. Recommendations for the Prevention and Treatment of Glucocorticoid-Induced Osteoporosis. American College of Rheumatology Ad Hoc Committee on Glucocorticoid-Induced Osteoporosis 2001; 44: 1496-1503. Go to original source...
    27. Saag KG. Prevention of Glucocorticoid-induced Osteoporosis. South Med J 2004; 97: 555-558. Go to original source... Go to PubMed...
    28. Geusens PP, de Nijs RNJ, Lems WF et al. Prevention of glucocorticoid osteoporosis: a consensus document of the Dutch Society for Rheumatology. Ann Rheum Dis 2004; 63: 324-325. Go to original source... Go to PubMed...
    29. Kanis JA, Stevenson M, McCloskey EV et al. Glucocorticoid-induced osteoporosis: a systematic review and cost-utility analysis. Health Technol Assess 2007; 11: 1-231. Go to original source... Go to PubMed...
    30. Odborné usmernenie MZ SR pre diagnostiku a liečbu osteoporózy. Vestník MZ SR 2006; 54: 9-16.

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