[Drug therapy of secondary osteoporosis: glucocorticoid-induced osteoporosis].
Only bisphosphonates have reliable evidence to decrease the risk of vertebral fractures in patients taking glucocorticoids. Relative risk at 1 year treatment with bisphosphonates for incident vertebral fractures and non-vertebral fractures were 0.46 (95% confidence interval: 0.28-0.77) and 0.77 (95% confidence interval: 0.39-1.51), respectively. Two year extension of the alendronate trial showed that relative risk for incident vertebral fractures was 0.10 (95% confidence interval: 0.01-0.90). The bisphosphonates have been recommended as first-line drugs and active vitamin D3 and vitamin K2 have been recommended as second-line drugs in Japanese guidelines on the management and treatment of glucocorticoid-induced osteoporosis of The Japanese Society for Bone and Mineral Research (2004 edition).
Department of Orthopaedic Surgery and Rheumatology, Nara Hospital, Kinki University School of Medicine.
Satoshi
S
Soen
D019386:Alendronate / Q000627:therapeutic use; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D002762:Cholecalciferol / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D004164:Diphosphonates / Q000627:therapeutic use; D005938:Glucocorticoids / Q000009:adverse effects*; D006801:Humans; D010024:Osteoporosis / Q000139:chemically induced* / Q000150:complications / Q000188:drug therapy*; D017410:Practice Guidelines as Topic; D016103:Spinal Fractures / Q000209:etiology / Q000517:prevention & control; D024482:Vitamin K 2 / Q000627:therapeutic use
D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D005938:Glucocorticoids; D024482:Vitamin K 2; D002762:Cholecalciferol; D019386:Alendronate