Abstract
Glucocorticoids can be lifesaving for patients with chronic inflammatory diseases and allergic conditions yet have devastating effects on the skeleton. Chronic glucocorticoid therapy is a common cause of drug-induced osteoporosis. This is a review of the epidemiology and pathophysiology of glucocorticoid-induced osteoporosis, the risk of bone loss and fractures, and strategies to reduce fracture risk in patients receiving glucocorticoid therapy. Patients on chronic glucocorticoids tend to fracture at higher bone density levels than those with postmenopausal osteoporosis and may have comorbidities, including sarcopenia and the underlying disease being treated, that contribute to falls risk and skeletal fragility. Fractures are associated with significant morbidity and mortality. Despite the availability of evidence-based clinical practice guidelines providing physicians with recommendations for interventions proven to reduce fracture risk, many patients are currently not being treated. Patients receiving long-term glucocorticoid therapy should be evaluated for fracture risk and treated appropriately to reduce the risk of fractures.
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Lewiecki, E.M. (2022). Glucocorticoid-Induced Osteoporosis. In: Bandeira, F., Gharib, H., Griz, L., Faria, M. (eds) Endocrinology and Diabetes. Springer, Cham. https://doi.org/10.1007/978-3-030-90684-9_26
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