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Diagnosis and treatment of
glucocorticoid-induced osteoporosis
D. Zaqqa and R.D. Jackson
Abstract
Glucocorticoids are a mainstay in the treatment
of many diseases, including pulmonary and rheumatologic disorders. Unfortunately, as many
as 90% of long-term glucocorticoid recipients lose a significant amount of bone and incur
an increased risk of fractures. This paper reviews the pathophysiology, diagnosis, and
treatment of glucocorticoid-induced osteoporosis.
Key Points
- Although bone loss increases with both the dose and duration of steroid use, a host of
other factors including diet, physical activity, cigarette smoking, and even the
underlying disease may contribute to the severity of the resultant osteoporosis.
- Risk stratification by dual energy x-ray absorptiometry, together with markers of
calcium homeostasis and gonadal steroid deficiency, can help to determine the appropriate
treatment.
- New drugs such as calcitriol and the bisphosphonates offer promise for preventing this
potentially devastating disease.
Authors
Dina Zaqqa, MD, Division of Endocrinology, Diabetes and Metabolism,
Department of Internal Medicine, Ohio State University
Rebecca D. Jackson, MD, Associate Professor, Division of
Endocrinology, Diabetes and Metabolism, Department of Internal Medicine, Ohio State
University
Address: Rebecca D. Jackson, MD, The Ohio State University, College of
Medicine and Public Health, 485 McCampbell Hall, 1581 Dodd Dr., Columbus, OH 43210
John D. Clough, M.D., editor-in-chief
Linda K. Hengstler, editor and publisher
Phillip E. Canuto, executive editor
Ray Borazanian, managing editor |
