Corticosteroid-induced osteoporosis.
Corticosteroid-induced osteoporosis is a major problem faced by rheumatologists, with up to 50% of patients at increased risk for vertebral fractures. Our current understanding of the pathophysiology of corticosteroid-induced osteoporosis suggests two basic problems: a reduction in bone formation and an increase in bone resorption leading to an overall reduction in bone mass. Adequate calcium and vitamin D intake, calcitonin, hormone-replacement therapy, and thiazide diuretics are of benefit in preventing corticosteroid-induced bone loss. Other therapies such as the bisphosphonates, fluoride, and anabolic steroids should be considered when fractures occur or ongoing bone loss is evident. A review of the literature outlining the pathophysiology, clinical features, assessment, and treatment is presented.
Adachi
J D
JD
Department of Medicine, St Joseph's Hospital, McMaster University, Hamilton, Ontario, Canada.
Bensen
W G
WG
Hodsman
A B
AB
D000305:Adrenal Cortex Hormones / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D010024:Osteoporosis / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000517:prevention & control*; D011859:Radiography
D000305:Adrenal Cortex Hormones