Fractures glucocorticoid-induced

There have been repeated reports of epidural lipomatosis, which can lead to spinal cord compression (48,49) or spinal fracture (50) in one instance, the excised lipomata contained brown fat, a phenomenon that may prove to be not unusual in glucocorticoid-induced lipomata (SEDA-16, 451). 

Clodronate 100 mg by intramuscular route once a week was effective in the prevention of glucocorticoid-induced bone loss and fractures in patients with arthritis compared with calcium 1000 mg/day and vitamin D 800 mg/day... 

Bisphosphonates are licensed for use in postmenopausal osteoporosis and glucocorticoid induced osteoporosis. They are often used in older women with osteoporosis and they are recommended by NICE as the first-line agent for the secondary prevention of osteoporotic fractures in postmenopausal women. Alendronate and etidronate are licensed for men with osteoporosis. 

Bisphosphonates are the best therapeutic choice for patients with glucocorticoid-induced osteoporosis. Bisphosphonates generally produce greater BMD increases than do other agents used to treat osteoporosis. They increase spine (4.3%) and femoral neck (2.1%) BMD, but to a lesser extent than in bisphosphonate users who do not take glucocorticoids. They also likely reduce the risk of vertebral fractures by approximately 50%. ... 

A meta-analysis has shown that alfacalcidol and calci-triol prevent bone loss induced by glucocorticoid (effect size = 0.43) but not fractures (242). 

---