Corticosteroid osteoporosis

Philip Sambrook, Nancy E Lane

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

Corticosteroids are widely used and effective agents for the control of many inflammatory diseases, but corticosteroid osteoporosis is a common problem associated with their long term high dose use. Prevention of corticosteroid osteoporosis is preferable to treatment of established corticosteroid bone loss. Several large double-blind controlled clinical trials in patients with corticosteroid osteoporosis have recently been published that provide new insights into its treatment. Based upon available evidence, the rank order of choice for prophylaxis would be a bisphosphonate followed by a vitamin D metabolite or an oestrogen type medication. Calcium alone appears to be unable to prevent rapid bone loss in patients starting corticosteroids, especially with prednisolone doses at 10 mg a day or greater. If an active vitamin D metabolite is used, calcium supplementation should be avoided unless dietary calcium intake is low. Hormone replacement therapy should be considered if hypogonadism is present. Since vertebral fracture is a common and important complication of high dose corticosteroid therapy, these findings suggest that rapid bone loss and hence fractures, can be prevented by prophylactic treatment. Although the follow-up data is limited, it is likely that such therapy needs to be continued beyond 12 months whilst patients continue significant doses of corticosteroid therapy.

Original languageEnglish (US)
Pages (from-to)401-413
Number of pages13
JournalBest Practice and Research: Clinical Rheumatology
Volume15
Issue number3
DOIs
StatePublished - 2001
Externally publishedYes

Fingerprint

Osteoporosis
Adrenal Cortex Hormones
Bone and Bones
Vitamin D
Therapeutics
Calcium
Dietary Calcium
Hypogonadism
Hormone Replacement Therapy
Controlled Clinical Trials
Diphosphonates
Prednisolone
Estrogens

Keywords

  • Avascular necrosis
  • Bone mineral density
  • Fracture
  • Glucocorticoids
  • Osteoporosis

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Rheumatology

Cite this

Corticosteroid osteoporosis. / Sambrook, Philip; Lane, Nancy E.

In: Best Practice and Research: Clinical Rheumatology, Vol. 15, No. 3, 2001, p. 401-413.

Research output: Contribution to journalArticle

Sambrook, Philip ; Lane, Nancy E. / Corticosteroid osteoporosis. In: Best Practice and Research: Clinical Rheumatology. 2001 ; Vol. 15, No. 3. pp. 401-413.
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