title: Glucocorticoid-induced osteoporosis and osteonecrosis.
abstract: Glucocorticoid administration is the most common cause of secondary osteoporosis and the leading cause of nontraumatic osteonecrosis. In patients receiving long-term therapy, glucocorticoids induce fractures in 30% to 50% and osteonecrosis in 9% to 40%. This article reviews glucocorticoid-induced osteoporosis and osteonecrosis, addressing the risk factors, pathogenesis, evaluation, treatment, and uncertainties in the clinical management of these disorders.
authors.affiliation: Division of Endocrinology and Metabolism, Center for Osteoporosis and Metabolic Bone Diseases, Department of Internal Medicine, and Central Arkansas Veterans Healthcare System at the University of Arkansas for Medical Sciences, 4301 West Markham Street, Slot 587, Little Rock, AR 72205-7199, USA. weinsteinroberts@uams.edu
authors.forename: Robert S
authors.initials: RS
authors.lastname: Weinstein
mesh_terms: D061067:Antibodies, Monoclonal, Humanized / Q000494:pharmacology / Q000627:therapeutic use; D017209:Apoptosis / Q000187:drug effects; D050071:Bone Density Conservation Agents / Q000494:pharmacology / Q000627:therapeutic use; D001842:Bone and Bones / Q000187:drug effects* / Q000378:metabolism; D000069448:Denosumab; D004164:Diphosphonates / Q000494:pharmacology / Q000627:therapeutic use; D016903:Drug Monitoring; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects*; D006801:Humans; D008297:Male; D010006:Osteoblasts / Q000187:drug effects / Q000378:metabolism; D010011:Osteocytes / Q000187:drug effects / Q000378:metabolism; D010020:Osteonecrosis / Q000139:chemically induced* / Q000188:drug therapy / Q000503:physiopathology; D010024:Osteoporosis / Q000139:chemically induced* / Q000188:drug therapy / Q000503:physiopathology; D058866:Osteoporotic Fractures / Q000209:etiology / Q000517:prevention & control; D019379:Teriparatide / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D005938:Glucocorticoids; D019379:Teriparatide; D000069448:Denosumab