When to Start and Stop Bone-Protecting Medication for Preventing Glucocorticoid-Induced Osteoporosis


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Date

2021-12-15

Publication Type

Review Article

ETH Bibliography

yes

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Abstract

Glucocorticoid-induced osteoporosis (GIOP) leads to fractures in up to 40% of patients with chronic glucocorticoid (GC) therapy when left untreated. GCs rapidly increase fracture risk, and thus many patients with anticipated chronic GC exposures should start anti-osteoporosis pharmacotherapy to prevent fractures. In addition to low awareness of the need for anti-osteoporosis therapy among clinicians treating patients with GCs, a major barrier to prevention of fractures from GIOP is a lack of clear guideline recommendations on when to start and stop anti-osteoporosis treatment in patients with GC use. The aim of this narrative review is to summarize current evidence and provide considerations for the duration of anti-osteoporosis treatment in patients taking GCs based on pre-clinical, clinical, epidemiologic, and pharmacologic evidence. We review the pathophysiology of GIOP, outline current guideline recommendations on initiating and stopping anti-osteoporosis therapy for GIOP, and present considerations for the duration of anti-osteoporosis treatment based on existing evidence. In each section, we illustrate major points through a patient case example. Finally, we conclude with proposed areas for future research and emerging areas of interest related to GIOP clinical management.

Publication status

published

Editor

Book title

Volume

12

Pages / Article No.

782118

Publisher

Frontiers Media

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Date created

Subject

glucocorticoid-induced osteoporosis; glucocorticoids; bone fractures; bone density; anti-resorptive treatment; bone density conservation agents; bisphosphonates; teriparatide

Organisational unit

09633 - Burden, Andrea (ehemalig) / Burden, Andrea (former) check_circle

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Is referenced by:
Is referenced by: 10.3389/fendo.2022.877512