REVIEW - Steroid-induced osteoporosis

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Glucocorticoid-induced osteoporosis.

Endocrinology, diabetes and Obesity

Current Opinion in Internal Medicine. 7(1):18-22, February 2008.

Berris, Koenig; Repp, Anita Lopes; Kleerekoper,

Abstract:

Purpose of review: To present an overview of the peer-reviewed

literature relating to glucocorticoid-induced osteoporosis that has

been published since January 2006.

Recent findings: Understanding the pathophysiology of bone loss

resulting from glucocorticoid use has become clearer. The role of the

receptor-activated nuclear factor [kappa]B-ligand-osteoprotogerin

system has been clarified and will likely lead to better targeted

therapies. Minimal trauma fractures occur in patients treated with

glucocorticoids at higher bone mineral density than is seen with other

primary or secondary causes of osteoporosis. Uncertainty still remains

about the lowest dose of glucocorticoids that is not associated with

bone loss. Bisphosphonates remain the treatment of choice for

glucocorticoid-induced osteoporosis, but despite this effective

therapy the disease remains under recognized and undertreated.

Summary: Glucocorticoid-induced osteoporosis is a leading cause of

secondary osteoporosis, one of the more devastating consequences of

glucocorticoid therapy. Bone mineral density underestimates the risk

of fragility fractures in glucocorticoid-induced osteoporosis, which

may account for the underrecognition and undertreatment of the disease

prior to fracture.

http://www.co-internalmedicine.com/pt/re/cointernalmed/abstract.00132980-2008020\

00-00004.htm

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Not an MD