[Management of glucocorticoid-induced osteoporosis in childhood].
Bone turnover rate during growth is extremely rapid. Bone growth is under the control of various hormonal environments. Long term administration of glucocorticoid in childhood induced not only osteoporosis but also growth failure via direct action on bone and cartilage and indirectly via hormonal derangements. Sex steroid is one of the important hormones for the bone mineral accrual and for cartilage maturation. Thus glucocorticoid usage during puberty resulted in irreversible effect on bone health including bone growth and peak bone mass accrual. Recently bisphosphonates have been widely used in the treatment of these steroid induced bone disorders in adult with large amount of evidences. But in pediatrics, we are far from the firm evidences. Large scale randomized controlled study (RCT) is necessary.
Tanaka
Hiroyuki
H
Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Department of Pediatrics.
D000328:Adult; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D001846:Bone Development / Q000187:drug effects; D002648:Child; D004164:Diphosphonates / Q000627:therapeutic use*; D019317:Evidence-Based Medicine; D005938:Glucocorticoids / Q000009:adverse effects*; D006801:Humans; D010024:Osteoporosis / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy* / Q000517:prevention & control; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic
D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D005938:Glucocorticoids