, Volume 32, Issue 4, pp 337-350
Date: 13 May 2014

Guidelines on the management and treatment of glucocorticoid-induced osteoporosis of the Japanese Society for Bone and Mineral Research: 2014 update

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Glucocorticoids (GCs) are widely used to treat various inflammatory, immunologic, and allergic disorders that cause rheumatic, respiratory, bowel, hepatic, neurological, renal, and skin diseases. Osteoporosis is the most common and important adverse effect of GC therapy, and fractures occur in 30–50 % of adult patients receiving long-term GC therapy [1, 2]. Glucocorticoid-induced osteoporosis (GIO) is the most common type of secondary osteoporosis, and it occurs in patients of all ages, from children to the elderly.

An early rapid decrease of bone mineral density (8–12 %) occurs within several months of starting GC therapy, although bone mineral density decreases more slowly thereafter, with the annual loss being approximately 2–4 % [3]. In addition, it is known that there is a significant increase in the risk of vertebral and hip fractures before marked bone loss occurs [4]. Therefore, it is important to prevent early bone loss and to decrease in fracture risk as early as p