REVIEW - Preventing steroid-induced osteoporosis

[Guest guest]

Indian Journal of Dermatology, Venereology and Leprology

SPECIALTY INTERFACE

Year : 2008 | Volume : 74 | Issue : 1 | Page : 5-7

Preventing steroid induced osteoporosis

Oak Jyotsna

Division of Rheumatology, Department of Medicine, LTM Medical College

& LTM General Hospital, Sion, Mumbai, India

The most frequently encountered secondary cause of osteoporosis is

steroid induced osteoporosis (SIOP). The association between Cushing's

syndrome and osteoporosis has been recognized since 1932 when Harvey

Cushing first described the clinical features of endogenous

hypercortisolism.

Since corticosteroids were first used therapeutically in 1948, it has

been apparent that exogenous steroids are associated with development

of osteoporosis. The extent of bone loss with steroid therapy depends

on underlying disease and duration of therapy. Steroids have greater

effect on trabecular than on cortical bone, thus the reduction in bone

mass is more marked in the spine and proximal femur than in forearm or

femoral shaft. The reduction in bone mass associated with CS therapy

appears to be greater in rheumatoid arthritis (RA) than in asthma or

polymyalgia rheumatica, because of the effect of RA on bone loss.

Histological and densitometric studies suggest that the bone loss

occurs within a few months of starting CS therapy. The rate of bone

loss has been correlated with the daily CS dose, cumulative dose of CS

and duration of therapy.

The reduction in bone mass observed with CS therapy is associated with

increased risk of fractures, particularly of the vertebrae, ribs and

pelvis. The prevalence of fractures in patients treated with oral CS

has been reported to be between 11 and 20%.

***************************************************

Read the full article here:

http://www.ijdvl.com/article.asp?issn=0378-6323;year=2008;volume=74;issue=1;spag\

e=5;epage=7;aulast=Oak

--

Not an MD