[Guidelines for the treatment of glucocorticoid-induced osteoporosis and their future problems].
Osteoporosis is the most frequent adverse effect of glucocorticoids. Management guidelines for glucocorticoid-induced osteoporosis have been established in the United States, the United Kingdom, and many other countries. The 2004 edition of the guidelines on the management and treatment of glucocorticoid-induced osteoporosis have been proposed by The Japanese Society for Bone and Mineral Research. The subjects were patients with using or planning to use oral glucocorticoids for 3 months or longer. The criterion for starting treatment was patients with prior fragility fracture and with new fractures during treatment, patients with less bone mineral density (BMD) than 80% of young adult mean, and patients with using as a dose of 5mg/day or higher (mean daily dose) as prednisolone equivalent. The bisphosphonates have been recommended as first-line drugs and active vitamin D(3) and vitamin K(2) have been recommended as second-line drugs.
Soen
Satoshi
S
Kinki University School of Medicine, Nara Hospital, Department of Orthopaedic Surgery and Rheumatology.
D015519:Bone Density; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D002762:Cholecalciferol / Q000627:therapeutic use*; D004164:Diphosphonates / Q000627:therapeutic use*; D019317:Evidence-Based Medicine; D050723:Fractures, Bone / Q000209:etiology / Q000517:prevention & control; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D007564:Japan; D010024:Osteoporosis / Q000139:chemically induced* / Q000150:complications / Q000188:drug therapy* / Q000517:prevention & control; D017410:Practice Guidelines as Topic; D011239:Prednisolone / Q000008:administration & dosage / Q000009:adverse effects; D013997:Time Factors; D024482:Vitamin K 2 / Q000627:therapeutic use*
D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D005938:Glucocorticoids; D024482:Vitamin K 2; D002762:Cholecalciferol; D011239:Prednisolone