Management of steroid-induced osteoporosis in premenopausal women with autoimmune disease

[Guest guest]

Autoimmun Rev. 2003 Jun;2(4):224-8.

Management of glucocorticoid induced osteoporosis in premenopausal women

with autoimmune disease.

Franchimont N, Canalis E.

Rheumatology, University of Liege, CHU Sart-Tilman, 4000 Liege, Belgium.

nfranchimont@...

Numerous inflammatory rheumatic diseases occurring in premenopausal

women require the use of high doses of glucocorticoids (GC). It was

believed for many years that premenopausal women were, at least to some

extent, protected from bone loss associated with GC therapy. However,

epidemiological studies performed in premenopausal women with systemic

lupus erythematosus, demonstrate that these patients have lower bone

mineral density as compared to age-matched controls. This is explained

in part by the underlying disease and in part by treatment with GC. The

American College of Rheumatology recommends life style adaptation,

supplementation with calcium and vitamin D in patients receiving, or

initiating therapy with >/=5 mg equivalent prednisone/day.

Bisphosphonates are recommended, but they should be used with caution in

young women as they cross the placenta and can affect skeletal

remodeling in the foetus. Bisphosphonates have a prolonged terminal

half-life and data on their safety extends to 10 years. It is therefore

critical to inform premenopausal women about the risks of

bisphosphonates and to recommend bisphosphonates with shorter terminal

half-life.

PMID: 12848950

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org