Osteoporosis glucocorticoid-induced disease

Treatment and prevention of postmenopausal osteoporosis glucocorticoid-induced osteoporosis osteoporosis in men Paget s disease... 

There have been reviews of the mechanisms and adverse effects of glucocorticoids in rheumatoid arthritis (205) and the pathogenesis, diagnosis, and treatment of glucocorticoid-induced osteoporosis in patients with pulmonary diseases (206). Several mechanisms underlie the effect of glucocorticoids on bone, both biochemical and cellular. Effects on calcium are ... 

Goldstein MF, Fallon JJ Jr, Haming R. Chronic glucocorticoid therapy-induced osteoporosis in patients with obstructive lung disease. Chest 1999 116(6) l 733—49. Yosipovitch G, Hoon TS, Leok GC. Suggested rationale for prevention and treatment of glucocorticoid-induced bone loss in dermatologic patients. Arch Dermatol 2001 137(4) 477-81. 

Gluck O, Colice G. Recognizing and treating glucocorticoid-induced osteoporosis in patients with pulmonary diseases. Chest 2004 125 1859-76. 

It can occur in the presence of particular hormonal disorders and chronic diseases, or as a result of medications, specifically glucocorticoids (steroid- or glucocorticoid-induced osteoporosis). A major risk factor for osteoporosis in both men and women is advanced age. In females, oestrogen deficiency following menopause is correlated with a rapid reduction in BMD, while in men a decrease in testosterone has a comparable (bnt less pronounced) effect. European or Asian ancestry predisposes for osteoporosis. 

Boling EP. Secondary osteoporosis Underlying disease and the risk for glucocorticoid-induced osteoporosis. Clin Ther 2004 26 1-14. 

Risedronate sodium is a bisphosphonate that inhibits normal and abnormal bone resorption. It is indicated in the treatment of osteoporosis in postmenopausal women the prevention of osteoporosis in postmenopausal women at risk of developing osteoporosis the prevention and treatment of glucocorticoid-induced osteoporosis in men and women and in the treatment of Paget s disease of the bone. 

Unfortunately steroids merely suppress the inflammation while the underlying cause of the disease remains. Another serious concern about steroids is that of toxicity. The abmpt withdrawal of glucocorticoid steroids results in acute adrenal insufficiency. Long term use may induce osteoporosis, peptidic ulcers, the retention of fluid, or an increased susceptibiUty to infections. Because of these problems, steroids are rarely the first line of treatment for any inflammatory condition, and their use in rheumatoid arthritis begins after more conservative therapies have failed. 

Qassification Idiopathic osteoporosis type 1, occurring in postmenopausal females type 11, occurring in senescent males and females (>70 y). Secondary osteoporosis associated with primary disorders such as Cushing s disease, or induced by drugs, e.g chronic therapy with glucocorticoids or heparin. In these forms, the cause can be eliminated. 

Osteoporosis induced by chronic glucocorticoid therapy has been reviewed in patients with obstructive lung diseases (195) and patients with skin diseases (196). 

Goldstein MF, Fallon JJ Jr, Harning R. Chronic glucocorticoid therapy-induced osteoporosis in patients with obstructive lung disease. Chest 1999 116(6) 1733-49. 

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