title: 2014 update of recommendations on the prevention and treatment of  glucocorticoid-induced osteoporosis.
abstract: OBJECTIVE
  To update the recommendations on the prevention and treatment of glucocorticoid-induced osteoporosis issued in 2003 by the French National Authority for Health (HAS). This update was performed under the aegis of the Bone Section of the French Society for Rheumatology (SFR) and Osteoporosis Research and Information Group (GRIO), in collaboration with four French learned societies (primary-care, gastroenterology, internal medicine, and nephrology).
  
  
  METHODS
  A task force composed of members of the medical specialties involved in managing patients with glucocorticoid-induced osteoporosis conducted a systematic literature review according to the method developed by the HAS then used the results to develop updated recommendations.
  
  
  RESULTS
  These recommendations are intended for all physicians involved in the management of patients who are scheduled to start, or are taking, long-term glucocorticoid therapy (≥ 3 months) in any dose and for any reason. In postmenopausal women and men older than 50 years of age, treatment is warranted in the presence of any of the following risk factors for fracture: history of bone frailty fracture after 50 years of age, bone mineral density T-score ≤ −2.5 at one or more sites, age ≥ 70 years, and dosage ≥ 7.5 mg/d prednisone-equivalent for longer than 3 months. Bisphosphonates can be used in all these situations; teriparatide can be given as first-line therapy in patients at high fracture risk but is reimbursed by the French statutory health insurance system only in patients having two or more prevalent vertebral fractures. The fracture risk is lower in non-menopausal women and in men younger than 50 years of age,in whom treatment decisions should rest on a case-by-case evaluation.
  
  
  CONCLUSIONS
  These recommendations are intended to clarify the pharmacological management of glucocorticoid-induced osteoporosis.
authors.forename: Karine
authors.initials: K
authors.lastname: Briot
authors.forename: Bernard
authors.initials: B
authors.lastname: Cortet
authors.forename: Christian
authors.initials: C
authors.lastname: Roux
authors.forename: Laurence
authors.initials: L
authors.lastname: Fardet
authors.forename: Vered
authors.initials: V
authors.lastname: Abitbol
authors.forename: Justine
authors.initials: J
authors.lastname: Bacchetta
authors.forename: Daniel
authors.initials: D
authors.lastname: Buchon
authors.forename: Francoise
authors.initials: F
authors.lastname: Debiais
authors.forename: Pascal
authors.initials: P
authors.lastname: Guggenbuhl
authors.forename: Michel
authors.initials: M
authors.lastname: Laroche
authors.forename: Erik
authors.initials: E
authors.lastname: Legrand
authors.forename: Eric
authors.initials: E
authors.lastname: Lespessailles
authors.forename: Christian
authors.initials: C
authors.lastname: Marcelli
authors.forename: Georges
authors.initials: G
authors.lastname: Weryha
authors.forename: Thierry
authors.initials: T
authors.lastname: Thomas
mesh_terms: D001842:Bone and Bones / Q000187:drug effects; D005938:Glucocorticoids / Q000009:adverse effects*; D006801:Humans; D010024:Osteoporosis / Q000139:chemically induced* / Q000503:physiopathology / Q000517:prevention & control* / Q000628:therapy; D012307:Risk Factors
chemical_list: D005938:Glucocorticoids