Glucocorticoid-induced bone loss in dermatologic patients: an update.
OBJECTIVE
To raise awareness of the new treatment options and current recommendations among dermatologists treating patients with systemic corticosteroids.


METHODS
MEDLINE peer-reviewed publications.


METHODS
English language and clinical pertinence to corticosteroid-induced osteoporosis.


METHODS
Pertinent information on pathophysiologic, epidemiologic, clinical trial, cost-effectiveness, and treatment option data regarding corticosteroid-induced osteoporosis.


RESULTS
Comprehensive summary of published data on the pathophysiologic, epidemiologic, clinical, and treatment data and current practice guidelines regarding corticosteroid-induced osteoporosis; creation of an algorithmic management approach for patients treated with long-term oral corticosteroids.


CONCLUSIONS
Glucocorticoid-induced bone loss is the most predictable and debilitating complication of prolonged administration of systemic corticosteroids. Every dermatologist prescribing systemic corticosteroids must be aware of corticosteroid-induced osteoporosis and ensure that every patient is receiving general measures to prevent it. Despite efficacious preventive and therapeutic options, actual implementation of these strategies remains unacceptably low. Based on currently available evidence, the first choice for prevention and treatment of glucocorticoid-induced osteoporosis should be a potent oral bisphosphonate such as alendronate (70 mg/wk) or risedronate sodium (35 mg/wk). For patients with severe osteoporosis or patients with active osteoporotic fractures, the anabolic agent teriparatide (recombinant fragmented parathyroid hormone) should be considered as a first-line option for up to 2 years.
Summey
Brett T
BT
Department of Dermatology, Drexel University College of Medicine, Philadelphia, USA. summey@alumni.unc.edu
Yosipovitch
Gil
G
D005938:Glucocorticoids / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D010024:Osteoporosis / Q000139:chemically induced*; D012307:Risk Factors; D012871:Skin Diseases / Q000188:drug therapy*
D005938:Glucocorticoids