Glucocorticoids and the risk of osteoporosis.
BACKGROUND
Glucocorticoid-induced osteoporosis (GIO) refers to a clinical condition in which a class of corticosteroids increases the susceptibility of bones to fracture. Numerous recent studies have improved our understanding of the underlying biology of this condition, whereas data from randomized controlled trials have provided clinicians with more options for prevention of GIO.


OBJECTIVE
To review the pathophysiology and epidemiology of GIO, as well as current pharmacologic treatment and prevention modalities available. To review the state of healthcare provider concordance with GIO prevention guidelines.


METHODS
Representative examples of various cellular and molecular processes underlying GIO were included, with an emphasis towards more recent discoveries. The data used to describe the epidemiology of GIO were derived from both randomized controlled studies and observational studies, framed through a discussion of known osteoporosis risk factors.


CONCLUSIONS
Progress has been made in clarifying the pathophysiologic mechanisms that result in GIO. Although the options for preventions and treatment of GIO continue to expand, provider compliance with preventive measures remains suboptimal.
Caplan
Liron
L
University of Colorado Denver, Denver Veterans Affairs Medical Center, PO Box 6511, B115, Colorado 80045, Denver, USA. liron.caplan@uchsc.edu
Saag
Kenneth G
KG
D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D050723:Fractures, Bone / Q000139:chemically induced* / Q000517:prevention & control; D005938:Glucocorticoids / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D010024:Osteoporosis / Q000139:chemically induced* / Q000517:prevention & control / Q000628:therapy; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors
D050071:Bone Density Conservation Agents; D005938:Glucocorticoids