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.
- 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.