US and UK guidelines for glucocorticoid-induced osteoporosis: Similarities and differences
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Osteoporosis is a common and serious complication of glucocorticoid therapy. Recent advances in the epidemiology, pathophysiology, and management of glucocorticoid-induced osteoporosis have stimulated the development of guidelines for the prevention and treatment of this condition. In this report, the updated recommendations of the American College of Rheumatology and guidelines recently produced by the Bone and Tooth Society, National Osteoporosis Society, and Royal College of Physicians in the UK are discussed with respect to their similarities and differences.
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References and Recommended Reading
- 3.van Staa TP, Leufkens HGM, Abenhaim L, et al.: Use of oral corticosteroids and risk of fractures. J Bone Miner Res 2000, 15:993–1000. This paper utilizes information from the UK General Practice Research Database to document fracture risk at different doses of oral glucocorticoids. It demonstrates that the risk of fracture is increased even at doses lower than 7.5 mg oral prednisolone daily and that the increase in risk occurs during the first 3 to 6 months after starting glucocorticoids.PubMedCrossRefGoogle Scholar
- 12.Guidelines Working Group for the Bone and Tooth Society, National Osteoporosis Society and Royal College of Physicians: Glucocorticoid-induced osteoporosis: guidelines for prevention and treatment. London, UK: Royal College of Physicians; 2002.Google Scholar
- 15.Sambrook P: Corticosteroid osteoporosis: practical implications of recent trials. J Bone Miner Res 2000, 15:7645–7649.Google Scholar
- 16.Kanis JA, Johnell O, Oden A, et al.: Ten year probabilities of osteoporotic fractures according to BMD and diagnostic thresholds. Osteoporos Int 2001, 12:989–995. This paper highlights the strong effect of age as a risk factor for osteoporotic fracture, independent of bone mineral density, and emphasizes the importance of considering age when making decisions about intervention to prevent fracture.PubMedCrossRefGoogle Scholar
- 17.Johnell O, de Laet C, Johansson H, et al.: Oral corticosteroids increase fracture risk independently of BMD. Osteoporos Int 2002, 13(suppl):S14. This study provides evidence that glucocorticoids increase bone fragility independent of their effects on bone mineral density and provide a rationale for intervention at higher bone density levels than in postmenopausal osteoporosis.CrossRefGoogle Scholar
- 27.Homik J, Suarez-Almazor ME, Shea B, et al.: Calcium and vitamin D for corticosteroid-induced osteoporosis. In The Cochrane Library. Oxford: Update Software; 2000.Google Scholar