Perspectives

Fracture risk reduction in glucocorticoid-induced osteoporosis

Perspectives

Fracture risk reduction in glucocorticoid-induced osteoporosis

Weiwen Chen, Jacqueline Center

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Abstract

Patients requiring more than three months of glucocorticoid therapy should be assessed with regards to their fracture risk. Calcium and vitamin D supplementation is recommended as preventive therapy for all patients taking glucocorticoids, and pharmacological intervention should also be considered.

Key Points

  • Glucocorticoids have many direct effects on bone cells ultimately leading to reduced formation and increased resorption.
  • Increased risk of fracture is seen at higher bone mineral densities in patients taking glucocorticoids than those not taking glucocorticoids.
  • Assessment of fracture risk should be considered in any patient taking glucocorticoids for more than three months.
  • The lowest effective dose of glucocorticoids for the shortest possible time should be used.
  • Lifestyle factors should be optimised and appropriate pharmacological intervention considered in people taking glucocorticoids.