Glucocorticoid-induced osteoporosis: management update.
Osteoporosis due to glucocorticoid-induced osteoporosis (GIOP) for inflammatory disorders continues to be a common problem. Well-distributed guidelines have provided evidence-based recommendations for management, yet many patients have little attention paid to their increased fracture risk. The purpose of this article is to discuss how new treatments for GIOP may improve overall management. Intravenous zoledronic acid (ZA), an antiresorptive agent, and teriparatide (TPT), which stimulates osteoblasts, have received US Food and Drug Administration (FDA) approval for treating GIOP. ZA is appealing because one 15-min infusion covers the patient for a year and potentially will increase the proportion of GIOP patients who are treated. TPT makes physiologic sense because GIOP is mostly due to decreased osteoblast function, and TPT stimulates osteoblasts. Although there is only one small published study in humans with GIOP, denosumab is a potentially useful antiresorptive agent, if it is approved by the FDA. The efficacy and safety of these medications in GIOP are discussed.
Adler
Robert A
RA
Endocrinology and Metabolism (111P), McGuire Veterans Affairs Medical Center, 1201 Broad Rock Boulevard, Richmond, VA 23249, USA. Robert.adler@va.gov
D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D000069448:Denosumab; D004164:Diphosphonates / Q000627:therapeutic use*; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects; D006801:Humans; D007093:Imidazoles / Q000627:therapeutic use*; D008297:Male; D010024:Osteoporosis / Q000139:chemically induced / Q000188:drug therapy*; D053245:RANK Ligand / Q000627:therapeutic use*; D019379:Teriparatide / Q000627:therapeutic use*; D000077211:Zoledronic Acid
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D005938:Glucocorticoids; D007093:Imidazoles; D053245:RANK Ligand; D019379:Teriparatide; D000069448:Denosumab; D000077211:Zoledronic Acid