title: [Secondary osteoporosis or secondary contributors to bone loss in fracture. Therapeutic strategy for glucocorticoid-induced osteoporosis].
abstract: Glucocorticoid is widely used to treat a variety of diseases and causes a number of significant side effects. Glucocorticoid-induced osteoporosis (GIOP) is known as a serious adverse effect during long-term glucocorticoid therapy. Guideline in Japan recommends bisphosphonates as first-line drugs. Bisphosphonates increase bone mineral density (BMD) and reduce vertebral fracture risk in patient beginning or continuing glucocorticoid treatment. As well as increased bone resorption, GIOP could induce severe suppression of bone formation. Although bisphosphonates are effective for GIOP, anabolic therapeutic strategies should be considered as alternative therapy in GIOP. Teripatratide (PTH (1-34) ) , a bone anabolic drug, is widely used in primary osteoporosis with severe osteoporotic fracture or extremely low bone mass, and has been reported to increase BMD and to reduce the risk of fractures also in GIOP. Denosumab, an anti receptor activator of nuclear factor-κB ligand, recently approved as a drug for postmenopausal osteoporosis was also effective for GIOP in clinical trials, and would be new candidate to treat GIOP.
authors.affiliation: Clinical Pharmacotherapeutics I, Faculty of Pharmacy, Meijo University, Nagoya, Aichi, Japan.
authors.forename: Nobuki
authors.initials: N
authors.lastname: Hayakawa
authors.forename: Atsushi
authors.initials: A
authors.lastname: Suzuki
mesh_terms: D015519:Bone Density / Q000187:drug effects*; D050071:Bone Density Conservation Agents / Q000009:adverse effects / Q000627:therapeutic use*; D050723:Fractures, Bone / Q000139:chemically induced / Q000150:complications / Q000188:drug therapy*; D005938:Glucocorticoids / Q000009:adverse effects*; D006801:Humans; D007564:Japan; D010024:Osteoporosis / Q000139:chemically induced / Q000150:complications / Q000188:drug therapy*
chemical_list: D050071:Bone Density Conservation Agents; D005938:Glucocorticoids