Glucocorticoid-induced osteoporosis.
Glucocorticoid-induced osteoporosis is a significant problem in patients receiving glucocorticoids after transplantation and for the treatment of parenchymal renal disease and rheumatological disorders. Frequently, patients are not evaluated or treated appropriately for glucocorticoid-induced osteoporosis. Bone loss occurs early after the administration of high-dose glucocorticoid therapy. Elderly patients with low bone densities before the initiation of glucocorticoid therapy are at particular risk of developing significant bone loss that could result in fractures. New information is now available concerning the mechanisms by which glucocorticoid-associated bone disease occurs. New therapies with anti-resorptive agents such as bisphosphonates and with anabolic agents such as parathyroid hormone offer the prospect of effective treatment of glucocorticoid-induced osteoporosis.
Kumar
R
R
Divisions of Nephrology, Endocrinology and Metabolism, Department of Medicine, Mayo Clinic and Foundation, Rochester, Minnesota 55905, USA. rkumar@mayo.edu
D000818:Animals; D001842:Bone and Bones / Q000187:drug effects; D002118:Calcium / Q000627:therapeutic use; D004164:Diphosphonates / Q000627:therapeutic use; D005938:Glucocorticoids / Q000009:adverse effects* / Q000494:pharmacology; D020249:Hormone Replacement Therapy; D006801:Humans; D010024:Osteoporosis / Q000139:chemically induced* / Q000188:drug therapy; D010281:Parathyroid Hormone / Q000627:therapeutic use; D014807:Vitamin D / Q000627:therapeutic use
D004164:Diphosphonates; D005938:Glucocorticoids; D010281:Parathyroid Hormone; D014807:Vitamin D; D002118:Calcium