Glucocorticoids and osteoporosis.
In summary, patients who will remain on glucocorticoids for more than a few weeks are clearly at risk for osteoporosis. A list of therapeutic strategies is provided in Table 2. While our therapy remains inadequate at this time, newer agents are on the horizon. In the near future, it may be possible to recommend specific agents for prevention of osteoporosis. Until longer term studies are completed, careful attention to the method of glucocorticoid administration, maintenance of exercise, supplementation with Vitamin D if needed, and adequate calcium intake are the mainstays of prevention. Possible treatments in the near future may include newer bisphosphonates, growth factors, and newer forms of calcitonin.
Adler
R A
RA
Division of Endocrinology and Metabolism, McGuire Veterans Affairs Medical Center, Richmond, Virginia.
Rosen
C J
CJ
D002117:Calcitriol / Q000494:pharmacology; D005938:Glucocorticoids / Q000009:adverse effects* / Q000494:pharmacology; D006133:Growth Substances / Q000502:physiology; D006801:Humans; D010006:Osteoblasts / Q000187:drug effects / Q000502:physiology; D010010:Osteoclasts / Q000187:drug effects / Q000502:physiology; D010024:Osteoporosis / Q000139:chemically induced* / Q000628:therapy
D005938:Glucocorticoids; D006133:Growth Substances; D002117:Calcitriol