[Management of corticosteroid-induced osteoporosis].
Corticosteroid-induced osteoporosis is common but too often unrecognized, and its management remains insufficient. Bone loss is variable from one patient to another and thus difficult to predict, but all treated patients must be considered at risk. There are tools to assess absolute fracture risk in this case as there are for menopause-associated osteoporosis, and they may help guide the clinician in decision-making. Recent guidelines help the physician to define indications for bone mineral density testing and for therapeutic management. Bisphosphonates are currently the first-line treatment for patients with fractures or elevated fracture risk during corticosteroid treatment.
Orcel
Philippe
P
Fédération de rhumatologie, Centre Viggo Petersen, Hôpital Lariboisière, Paris (75). philippe.orcel@lrb.aphp.fr
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000009:adverse effects*; D000328:Adult; D000367:Age Factors; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000009:adverse effects; D002118:Calcium / Q000008:administration & dosage / Q000627:therapeutic use; D003348:Cortisone / Q000008:administration & dosage / Q000009:adverse effects; D004164:Diphosphonates / Q000008:administration & dosage / Q000627:therapeutic use*; D012968:Etidronic Acid / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D050723:Fractures, Bone / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000139:chemically induced* / Q000150:complications / Q000188:drug therapy / Q000517:prevention & control / Q000628:therapy; D015663:Osteoporosis, Postmenopausal / Q000139:chemically induced / Q000150:complications / Q000188:drug therapy / Q000517:prevention & control; D017410:Practice Guidelines as Topic; D011322:Primary Prevention; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D014807:Vitamin D / Q000008:administration & dosage / Q000627:therapeutic use
D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D004164:Diphosphonates; D014807:Vitamin D; D012968:Etidronic Acid; D002118:Calcium; D003348:Cortisone