Abstract
Postmenopausal women are at greatest risk of rapid bone loss and fracture with glucocorticoids and should be actively considered for prophylactic measures. In men and premenopausal women receiving glucocorticoids, the decision to use anti-osteoporosis prophylaxis is less clear and depends upon baseline bone mineral density [BMD], anticipated dose and duration of glucocorticoids. Based upon evidence the order of choice for prophylaxis would be a bisphosphonate followed by a vitamin D metabolite or hormone replacement therapy [HRT]. Calcium alone appears unable to prevent rapid bone loss in patients starting glucocorticoids. HRT should clearly be considered if hypogonadism is present. In patients receiving chronic low dose glucocorticoids, treatment with calcium and vitamin D may be sufficient to prevent further bone loss. However since fracture risk is a function of multiple factors including the degree of reduction in BMD as well as the duration of exposure, treatment with therapy to increase BMD will reduce fracture risk even in patients receiving chronic low dose glucocorticoids.
Keywords: osteoporosis, postmenopausal, bone mineral density, glucocorticoid therapy, histomorphometric picture, morphometric approach, cushings syndrome, alfacalcidol, mild hypercalcemia
Current Pharmaceutical Design
Title: Glucocorticoid Osteoporosis
Volume: 8 Issue: 21
Author(s): Philip N. Sambrook
Affiliation:
Keywords: osteoporosis, postmenopausal, bone mineral density, glucocorticoid therapy, histomorphometric picture, morphometric approach, cushings syndrome, alfacalcidol, mild hypercalcemia
Abstract: Postmenopausal women are at greatest risk of rapid bone loss and fracture with glucocorticoids and should be actively considered for prophylactic measures. In men and premenopausal women receiving glucocorticoids, the decision to use anti-osteoporosis prophylaxis is less clear and depends upon baseline bone mineral density [BMD], anticipated dose and duration of glucocorticoids. Based upon evidence the order of choice for prophylaxis would be a bisphosphonate followed by a vitamin D metabolite or hormone replacement therapy [HRT]. Calcium alone appears unable to prevent rapid bone loss in patients starting glucocorticoids. HRT should clearly be considered if hypogonadism is present. In patients receiving chronic low dose glucocorticoids, treatment with calcium and vitamin D may be sufficient to prevent further bone loss. However since fracture risk is a function of multiple factors including the degree of reduction in BMD as well as the duration of exposure, treatment with therapy to increase BMD will reduce fracture risk even in patients receiving chronic low dose glucocorticoids.
Export Options
About this article
Cite this article as:
Sambrook N. Philip, Glucocorticoid Osteoporosis, Current Pharmaceutical Design 2002; 8 (21) . https://dx.doi.org/10.2174/1381612023393648
DOI https://dx.doi.org/10.2174/1381612023393648 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
Call for Papers in Thematic Issues
"Tuberculosis Prevention, Diagnosis and Drug Discovery"
The Nobel Prize-winning discoveries of Mycobacterium tuberculosis and streptomycin have enabled an appropriate diagnosis and an effective treatment of tuberculosis (TB). Since then, many newer diagnosis methods and drugs have been saving millions of lives. Despite advances in the past, TB is still a leading cause of infectious disease mortality ...read more
Current Pharmaceutical challenges in the treatment and diagnosis of neurological dysfunctions
Neurological dysfunctions (MND, ALS, MS, PD, AD, HD, ALS, Autism, OCD etc..) present significant challenges in both diagnosis and treatment, often necessitating innovative approaches and therapeutic interventions. This thematic issue aims to explore the current pharmaceutical landscape surrounding neurological disorders, shedding light on the challenges faced by researchers, clinicians, and ...read more
Emerging and re-emerging diseases
Faced with a possible endemic situation of COVID-19, the world has experienced two important phenomena, the emergence of new infectious diseases and/or the resurgence of previously eradicated infectious diseases. Furthermore, the geographic distribution of such diseases has also undergone changes. This context, in turn, may have a strong relationship with ...read more
Melanoma and Non-Melanoma Skin Cancer Treatment: Standard of Care and Recent Advances
In this thematic issue, we aim to provide a standard of care of the diagnosis and treatment of melanoma and non-melanoma skin cancer. The editor will invite authors from different countries who will write review articles of melanoma and non-melanoma skin cancers. The Diagnosis, Staging, Surgical Treatment, Non-Surgical Treatment all ...read more
- 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
- Announcements
Related Articles
-
FTD and ALS: A Tale of Two Diseases
Current Alzheimer Research Sex Hormones and their Analogues in Neuroimmune Biology
Immunology, Endocrine & Metabolic Agents in Medicinal Chemistry (Discontinued) The Infectious Etiology of Alzheimer’s Disease
Current Neuropharmacology Targeting Mitochondrial Bioenergetics for Alzheimers Prevention and Treatment
Current Pharmaceutical Design Biological Predictors of Aging and Potential of FTIR to Study Age-related Diseases and Aging Metabolic Fingerprint
Current Metabolomics Reduced Mitochondrial Activity is Early and Steady in the Entorhinal Cortex but it is Mainly Unmodified in the Frontal Cortex in Alzheimer's Disease
Current Alzheimer Research Diagnostic and Pathophysiological Impact of FP-CIT SPECT in Parkinson s Disease
Central Nervous System Agents in Medicinal Chemistry p38 MAP Kinase Inhibitors as Anti inflammatory Agents
Mini-Reviews in Medicinal Chemistry Huntingtons Disease: The Value of Transcranial Meganetic Stimulation
Current Medicinal Chemistry Regulatory T Cells in Central Nervous System: in Health and Disease
Central Nervous System Agents in Medicinal Chemistry Treatment of Psoriasis: A Comprehensive Review of Entire Therapies
Current Drug Safety Increasing Hippocampal Neurogenesis: A Novel Mechanism for Antidepressant Drugs
Current Pharmaceutical Design Stem Cells, Self-Renewal and Cancer of the Gastric Epithelium
Current Medicinal Chemistry The CMT1A-REP Binary Repeat from Disease Causing Genomic Re-arrangements to a Role in Gene Evolution
Current Genomics Structure-to-function Relationship of Carbohydrates in the Mechanism of Lysosomal Storage Disorders (LSDs)
Current Organic Chemistry Neuroprotective Strategies in Glaucoma
Current Pharmaceutical Design Dogs with Cognitive Dysfunction Syndrome: A Natural Model of Alzheimer’s Disease
Current Alzheimer Research Mitochondrial Mutations in Atherosclerosis: New Solutions in Research and Possible Clinical Applications
Current Pharmaceutical Design Varicella-Zoster Virus Infections During Pregnancy: Epidemiology, Clinical Symptoms, Diagnosis, Prevention and Therapy
Current Pediatric Reviews Transforming Growth Factor-β Signaling in Motor Neuron Diseases
Current Molecular Medicine