Updates in epidemiology, pathophysiology and management strategies of glucocorticoid-induced osteoporosis.
Expert Rev Endocrinol Metab
; 15(4): 283-298, 2020 07.
Article
em En
| MEDLINE
| ID: mdl-32584619
ABSTRACT
INTRODUCTION:
Endogenous or exogenous (corticosteroid-induced) glucocorticoids (GCs) excess represents, together with diabetes, the most common cause of secondary osteoporosis. AREAS COVERED We present a comprehensive overview about the pathophysiology, clinical management and treatment of GCs induced osteoporosis (GIOP). According to PRISMA guidelines, a literature search identifying articles about bone and GCs was done. EXPERT OPINION Despite the progress over the years and the increase in therapeutic options, there still are controversial issues about the management of GIOP. These mainly include the failure of BMD or FRAX to completely account for the rapid increase in fracture risk of most GC-treated patients, the understanding about the independent contribution on bone fragility of the underlying disease requiring GCs therapy, and the necessity of clearer information about the anti-fracture efficacy and long term-safety of most therapeutic options. Moreover, there are no specific indications for the management of bone fragility in endogenous hypercortisolism. Notwithstanding the above limitations there is a general consensus to recommend an assessment of fracture risk in all individuals >40 years committed to receive (or continuing) high dose (>7.5 mg of prednisone equivalent) GCs for ≥3 months and in all patients with fragility fracture history.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Osteoporose
/
Fraturas por Osteoporose
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Glucocorticoides
Tipo de estudo:
Guideline
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Prognostic_studies
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Screening_studies
Idioma:
En
Revista:
Expert Rev Endocrinol Metab
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
Itália