Osteoporosis International

, Volume 23, Issue 9, pp 2257–2276

A framework for the development of guidelines for the management of glucocorticoid-induced osteoporosis

  • S. Lekamwasam
  • J. D. Adachi
  • D. Agnusdei
  • J. Bilezikian
  • S. Boonen
  • F. Borgström
  • C. Cooper
  • A. Diez Perez
  • R. Eastell
  • L. C. Hofbauer
  • J. A. Kanis
  • B. L. Langdahl
  • O. Lesnyak
  • R. Lorenc
  • E. McCloskey
  • O. D. Messina
  • N. Napoli
  • B. Obermayer-Pietsch
  • S. H. Ralston
  • P. N. Sambrook
  • S. Silverman
  • M. Sosa
  • J. Stepan
  • G. Suppan
  • D. A. Wahl
  • J. E. Compston
  • Joint IOF-ECTS GIO Guidelines Working Group
Position Paper

DOI: 10.1007/s00198-012-1958-1

Cite this article as:
Lekamwasam, S., Adachi, J.D., Agnusdei, D. et al. Osteoporos Int (2012) 23: 2257. doi:10.1007/s00198-012-1958-1

Abstract

Summary

This paper provides a framework for the development of national guidelines for the management of glucocorticoid-induced osteoporosis in men and women aged 18 years and over in whom oral glucocorticoid therapy is considered for 3 months or longer.

Introduction

The need for updated guidelines for Europe and other parts of the world was recognised by the International Osteoporosis Foundation and the European Calcified Tissue Society, which set up a joint Guideline Working Group at the end of 2010.

Methods and results

The epidemiology of GIO is reviewed. Assessment of risk used a fracture probability-based approach, and intervention thresholds were based on 10-year probabilities using FRAX. The efficacy of intervention was assessed by a systematic review.

Conclusions

Guidance for glucocorticoid-induced osteoporosis is updated in the light of new treatments and methods of assessment. National guidelines derived from this resource need to be tailored within the national healthcare framework of each country.

Keywords

Bone mineral densityBone-protective therapyFractureFRAXGlucocorticoids

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2012

Authors and Affiliations

  • S. Lekamwasam
    • 1
  • J. D. Adachi
    • 2
  • D. Agnusdei
    • 3
  • J. Bilezikian
    • 4
  • S. Boonen
    • 5
  • F. Borgström
    • 6
  • C. Cooper
    • 7
  • A. Diez Perez
    • 8
  • R. Eastell
    • 9
  • L. C. Hofbauer
    • 10
  • J. A. Kanis
    • 11
  • B. L. Langdahl
    • 12
  • O. Lesnyak
    • 13
  • R. Lorenc
    • 14
  • E. McCloskey
    • 9
  • O. D. Messina
    • 15
  • N. Napoli
    • 16
  • B. Obermayer-Pietsch
    • 17
  • S. H. Ralston
    • 18
  • P. N. Sambrook
    • 19
  • S. Silverman
    • 20
  • M. Sosa
    • 21
  • J. Stepan
    • 22
    • 23
  • G. Suppan
    • 24
  • D. A. Wahl
    • 26
  • J. E. Compston
    • 25
  • Joint IOF-ECTS GIO Guidelines Working Group
  1. 1.Department of Medicine, Faculty of MedicineCentre for Metabolic Bone DiseasesGalleSri Lanka
  2. 2.Division of Rheumatology, Department of MedicineMcMaster UniversityHamiltonCanada
  3. 3.Eli Lilly and Co.FlorenceItaly
  4. 4.College of Physicians and SurgeonsColumbia UniversityNew YorkUSA
  5. 5.Division of Gerontology and Geriatrics and Center for Musculoskeletal Research, Department of Experimental MedicineLeuven UniversityLeuvenBelgium
  6. 6.Quantify Research and LIME/MMCKarolinska InstitutetStockholmSweden
  7. 7.MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton and NIHR Musculoskeletal Biomedical Research Unit, Institute of Musculoskeletal SciencesUniversity of OxfordOxfordUK
  8. 8.Hospital del Mar-IMIM-Universitat AutónomaBarcelonaSpain
  9. 9.Academic Unit of Bone Metabolism, University of Sheffield and NIHR Musculoskeletal Biomedical Research UnitSheffield Teaching Hospitals NHS TrustSheffieldUK
  10. 10.Division of Endocrinology, Diabetes, and Bone Diseases, Department of Medicine IIIDresden Technical University Medical CenterDresdenGermany
  11. 11.Centre for Metabolic Bone Diseases (WHO Collaborating Centre)University of Sheffield Medical SchoolSheffieldUK
  12. 12.Department of EndocrinologyAarhus University HospitalAarhusDenmark
  13. 13.Russian Association on OsteoporosisYekaterinburgRussia
  14. 14.Department of Biochemistry and Experimental MedicineThe Children’s Memorial Health InstituteWarsawPoland
  15. 15.Department of RheumatologyC. Argerich HospitalBuenos AiresArgentina
  16. 16.Division of EndocrinologyCampus Bio-Medico UniversityRomeItaly
  17. 17.Division of Endocrinology and Metabolism, Department of Internal MedicineMedical University of GrazGrazAustria
  18. 18.Rheumatic Diseases Unit, Molecular Medicine Centre, Institute of Genetics and Molecular Medicine, Western General HospitalUniversity of EdinburghEdinburghUK
  19. 19.University of Sydney-Royal North Shore HospitalSt LeonardsAustralia
  20. 20.Cedars-Sinai/University of CaliforniaLos AngelesUSA
  21. 21.Investigation Group on Osteoporosis, Hospital University Insular, Bone Metabolic UnitUniversity of Las Palmas de Gran CanariaLas Palmas de Gran CanariaSpain
  22. 22.Institute of RheumatologyPragueCzech Republic
  23. 23.Faculty of Medicine 1Charles UniversityPragueCzech Republic
  24. 24.Action for Healthy BonesGrazAustria
  25. 25.International Osteoporosis FoundationNyonSwitzerland
  26. 26.Department of MedicineCambridge University Hospitals NHS Foundation TrustCambridgeUK