title: Steroid-induced osteoporosis.
abstract: BACKGROUND
  Corticosteroids have major effects on calcium metabolism, leading to accelerated osteoporosis and fracture.
  
  
  METHODS
  This review will attempt to summarise current knowledge about their effects in light of new information and important remaining questions, especially with respect to management of this common condition.
  
  
  RESULTS
  Corticosteroids affect bone through multiple pathways, influencing both bone formation and bone resorption. Evidence from randomised trials suggests that postmenopausal women receiving corticosteroids are at greatest risk of rapid bone loss and consequent fracture and should be actively considered for prophylaxis. Based upon available evidence, the rank order of choice for prophylaxis would be a bisphosphonate followed by a vitamin D metabolite or hormone replacement.
  
  
  CONCLUSIONS
  With early therapy, corticosteroid bone loss can be effectively prevented or reversed.
authors.affiliation: Institute of Bone & Joint Research, University of Sydney, Sydney, Australia. sambrook@med.usyd.edu.au
authors.forename: P N
authors.initials: PN
authors.lastname: Sambrook
mesh_terms: D000305:Adrenal Cortex Hormones / Q000009:adverse effects* / Q000627:therapeutic use; D001315:Australia / Q000453:epidemiology; D015519:Bone Density / Q000502:physiology; D002118:Calcium / Q000378:metabolism*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005598:Fractures, Spontaneous / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D015994:Incidence; D008134:Long-Term Care; D008297:Male; D010024:Osteoporosis / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology*; D011322:Primary Prevention / Q000379:methods; D011379:Prognosis; D012307:Risk Factors
chemical_list: D000305:Adrenal Cortex Hormones; D002118:Calcium