Abstract
Oral corticosteroids are associated with an increased risk of fractures from negative effects on sex steroids and vitamin D with a negative calcium balance, together with negative effects on the bone cells and the bone matrix. However, the increase in fracture risk with oral corticosteroids seems more linked to daily than to cumulative dose. A small daily dose may consequently be more detrimental than a large cumulative dose given as intermittent doses. Topical corticosteroids administered locally in the eyes, ears, in the mouth, on the skin, and rectally are not associated with an increased risk of fractures. Inhaled corticosteroids are not associated with an increased risk of fractures, except at very high doses that are much higher than the doses usually administered. With regard to the prevention of fractures, the use of topical corticosteroids may be preferred over oral administration where feasible. More research is needed to determine practically applicable intermittent dosing regimens for corticosteroids, replacing daily administration, to assess if this can have the same beneficial clinical effect but avoid, or at least reduce, the risk of osteoporosis and fractures.
Keywords: Corticosteroids, Skeletal Effects, sex steroids, vitamin D, bone cells, bone matrix, osteoporosis
Current Drug Safety
Title: Skeletal Effects of Systemic and Topical Corticosteroids
Volume: 3 Issue: 3
Author(s): Peter Vestergaard
Affiliation:
Keywords: Corticosteroids, Skeletal Effects, sex steroids, vitamin D, bone cells, bone matrix, osteoporosis
Abstract: Oral corticosteroids are associated with an increased risk of fractures from negative effects on sex steroids and vitamin D with a negative calcium balance, together with negative effects on the bone cells and the bone matrix. However, the increase in fracture risk with oral corticosteroids seems more linked to daily than to cumulative dose. A small daily dose may consequently be more detrimental than a large cumulative dose given as intermittent doses. Topical corticosteroids administered locally in the eyes, ears, in the mouth, on the skin, and rectally are not associated with an increased risk of fractures. Inhaled corticosteroids are not associated with an increased risk of fractures, except at very high doses that are much higher than the doses usually administered. With regard to the prevention of fractures, the use of topical corticosteroids may be preferred over oral administration where feasible. More research is needed to determine practically applicable intermittent dosing regimens for corticosteroids, replacing daily administration, to assess if this can have the same beneficial clinical effect but avoid, or at least reduce, the risk of osteoporosis and fractures.
Export Options
About this article
Cite this article as:
Vestergaard Peter, Skeletal Effects of Systemic and Topical Corticosteroids, Current Drug Safety 2008; 3 (3) . https://dx.doi.org/10.2174/157488608785699487
DOI https://dx.doi.org/10.2174/157488608785699487 |
Print ISSN 1574-8863 |
Publisher Name Bentham Science Publisher |
Online ISSN 2212-3911 |
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
Related Articles
-
Regulation of Apoptosis by Gram-Positive Bacteria: Mechanistic Diversity and Consequences for Immunity
Current Immunology Reviews (Discontinued) Anti-obesity Agents: A Focused Review on the Structural Classification of Therapeutic Entities
Current Topics in Medicinal Chemistry BST-2 Expression in Human Hepatocytes is Inducible by All Three Types of Interferons and Restricts Production of Hepatitis C Virus
Current Molecular Medicine A Narrative Review on Dialectical Behavior Therapy for Patients with Depressive Difficulties
Current Psychiatry Research and Reviews Applications of Genome Editing Tools in Stem Cells Towards Regenerative Medicine: An Update
Current Stem Cell Research & Therapy The Role of Intracellular 35-Cyclic Adenosine Monophosphate (cAMP) in Atherosclerosis
Current Vascular Pharmacology Neurological Aspects of Medical Use of Cannabidiol
CNS & Neurological Disorders - Drug Targets Novel Natural and Synthetic Ligands of the Endocannabinoid System
Current Medicinal Chemistry Gender Bias in Acute Coronary Syndromes
Current Vascular Pharmacology The Involvement of PPARs in the Causes, Consequences and Mechanisms for Correction of Cardiac Lipotoxicity and Oxidative Stress
Current Molecular Pharmacology HIV-1 Vpr: A Closer Look at the Multifunctional Protein from the Structural Perspective
Current HIV Research Boronated DNA-Binding Compounds as Potential Agents for Boron Neutron Capture Therapy
Mini-Reviews in Medicinal Chemistry GPCR Drug Discovery: Novel Ligands for CNS Receptors
Recent Patents on CNS Drug Discovery (Discontinued) mGlu5, Dopamine D<sub>2</sub> and Adenosine A<sub>2A</sub> Receptors in L-DOPA-induced Dyskinesias
Current Neuropharmacology Positional Cloning in Mice and Its Use For Molecular Dissection of Inflammatory Arthritis
Current Pharmaceutical Biotechnology Current Status of the Non-nucleoside Reverse Transcriptase Inhibitors of Human Immunodeficiency Virus Type 1
Current Topics in Medicinal Chemistry Factors Affecting Sexual Transmission of HIV-1: Current Evidence and Implications for Prevention
Current HIV Research Endothelins and the Role of Endothelin Antagonists in the Management of Posttraumatic Vasospasm
Current Pharmaceutical Design Non-Nucleoside HIV-1 Reverse Transcriptase (RT) Inhibitors: Past, Present, and Future Perspectives
Current Pharmaceutical Design Endovascular Treatment of Pulmonary and Cerebral Arteriovenous Malformations in Patients Affected by Hereditary Haemorrhagic Teleangiectasia
Current Pharmaceutical Design