[Prevention of cortisone-induced osteoporosis: who, when and what?].
Glucocorticoid-induced osteoporosis is a known phenomenon with already an increased fracture risk at 2.5 mg of prednisone daily over 3 months. This risk appears to be independent of bone densitometry results, in contradiction with published guidelines. With the creation of our Department of Musculoskeletal Medicine, we wanted to edict clear recommendations for the prevention of steroid-induced osteoporosis. In addition to the standard general measures to prevent osteoporosis and calcium and vitamin D supplementation, we advocate the use of a specific treatment for osteoporosis in all cases when the duration of corticosteroid therapy is not strictly limited and shorter than 3 months. Bisphosphonates are the treatment of choice, while the analogue of parathyroid hormone remains an alternative in cases with a very high fracture risk.
Aubry-Rozier
Bérengère
B
Centre des maladies osseuses, Hôpital orthopédique, Avenue Pierre-Decker 4, CHUV, 1011 Lausanne. berengere.aubry@chuv.ch
Lamy
Olivier
O
Dudler
Jean
J
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000009:adverse effects; D003348:Cortisone / Q000008:administration & dosage / Q000009:adverse effects*; D004334:Drug Administration Schedule; D050723:Fractures, Bone / Q000453:epidemiology / Q000517:prevention & control; D006801:Humans; D008875:Middle Aged; D010024:Osteoporosis / Q000139:chemically induced* / Q000517:prevention & control
D000893:Anti-Inflammatory Agents; D003348:Cortisone