[Pharmacological prevention of osteoporosis in patients on corticosteroid medication].
Twenty-five per cent of the patients using corticosteroids for long periods of time develops at least one fracture. Corticosteroids lead to osteoporosis through increase of renal calcium excretion and decrease of intestinal calcium absorption, bone formation by osteoblasts and serum levels of sex hormones. In spite of guidelines according to which patients protractedly using corticosteroids should take sufficient calcium and cholecalciferol, only about one-tenth of them takes any form of medication to prevent osteoporosis. It seems advisable to prescribe additional anti-osteoporosis medication for patients using > or = 7.5 mg prednisone during at least 3 months and who have a low mineral density of bone; only of biphosphonates a preventive effect clearly has been demonstrated. For postmenopausal women, hormonal supplementation therapy may offer additional benefit, reducing the risk of cardiovascular disease.
Lems
W F
WF
Afd. Reumatologie, Academisch Ziekenhuis Vrije Universiteit, Amsterdam.
Jacobs
J W
JW
Netelenbos
J C
JC
Dijkmans
B A
BA
Bijlsma
J W
JW
D000305:Adrenal Cortex Hormones / Q000009:adverse effects; D015519:Bone Density / Q000187:drug effects; D017610:Calcium Compounds / Q000494:pharmacology / Q000627:therapeutic use*; D002762:Cholecalciferol / Q000494:pharmacology / Q000627:therapeutic use*; D004164:Diphosphonates / Q000494:pharmacology / Q000627:therapeutic use*; D015914:Estrogen Replacement Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000139:chemically induced / Q000517:prevention & control*
D000305:Adrenal Cortex Hormones; D017610:Calcium Compounds; D004164:Diphosphonates; D002762:Cholecalciferol
Medicamenteuze preventie van osteoporose bij gebruik van corticosteroïden.