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Treatment of glucocorticoid-induced osteoporosis

Department of Medicine, College of Physicians and Surgeons, 630 W. 168th Street, New York, NY, 10032, USA

Andrea Giustina

Department of Internal Medicine, University of Brescia, Italy

Ernesto Canalis

Department of Research, Saint Francis Hospital and Medical Center, Hartford, CT, University of Connecticut School of Medicine, CT, USA

John P. Bilezikian

Department of Internal Medicine, University of Brescia, Italy, jpb2{at}columbia.edu

Glucocorticoid-induced osteoporosis (GIO) is the most common form of secondary osteoporosis. Fractures occur in 30—50% of patients with GIO. Therefore, treatment of this disease is critical. Although patients should receive supplemental calcium and vitamin D, additional measures are necessary to prevent fractures. Estrogens and androgens may be of value in patients with hypogonadism, but bisphosphonates and teriparatide are the most effective agents in the treatment of GIO. Bisphosphonates prevent the early bone loss that follows exposure to glucocorticoids, and which has been attributed to increased resorption. Teriparatide appears to be more effective than alendronate in established GIO when reduced bone formation is the predominant pathophysiological mechanism. In conclusion, GIO can be prevented and treated with appropriate medical intervention.

Key Words: osteoporosis • glucocorticosteroids • bisphosphonates • teriparatide

Therapeutic Advances in Musculoskeletal Disease, Vol. 1, No. 1, 27-34 (2009)
DOI: 10.1177/1759720X09343222


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