title: [Glucocorticoid and bone].
abstract: Oral glucocorticoids are prescribed for a wide variety of medical disorders. Reduced bone formation is the key process in glucocorticoid-induced osteoporosis. Glucocorticoid-induced osteoporosis is characterized by relative dissociation between the BMD values and the fracture risk, which is higher than expected based on the BMD values. 2014 revised Japanese guidelines indicated that Age, GC dose, lumbar BMD, and prior fragility fractures were identified as factors predicting future fracture and each factor was scored according to the category. Since an age of 65 years or older, prednisolone dose of 7.5mg/day or more, and a history of fragility fracture are independent risk for future fractures, initiation of drug therapy can be decided more easily without evaluation of BMD by DXA when one of these risk factors exists. Alendronate and risedronate were recommended as first-line treatment and teriparatide (rDNA origin) , ibandronate, alfacalcidol and calcitriol were recommended as alternative option.
authors.affiliation: Department of Orthopaedic Surgery and Rheumatology, Nara Hospital, Kinki University School of Medicine, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Soen
mesh_terms: D060433:Administration, Ophthalmic; D000328:Adult; D000368:Aged; D019386:Alendronate / Q000627:therapeutic use; D000818:Animals; D015519:Bone Density / Q000187:drug effects; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D012968:Etidronic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D005260:Female; D050723:Fractures, Bone / Q000139:chemically induced; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D008297:Male; D051379:Mice; D008875:Middle Aged; D010012:Osteogenesis / Q000187:drug effects; D010024:Osteoporosis / Q000139:chemically induced* / Q000188:drug therapy / Q000378:metabolism; D017410:Practice Guidelines as Topic; D011239:Prednisolone / Q000008:administration & dosage / Q000009:adverse effects*; D000068296:Risedronic Acid; D012306:Risk; D019379:Teriparatide / Q000627:therapeutic use
chemical_list: D050071:Bone Density Conservation Agents; D005938:Glucocorticoids; D019379:Teriparatide; D011239:Prednisolone; D000068296:Risedronic Acid; D012968:Etidronic Acid; D019386:Alendronate