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Glucocorticoid-induced osteoporosis: pathophysiological role of GH/IGF-I and PTH/VITAMIN D axes, treatment options and guidelines

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Abstract

Glucocorticoid-induced osteoporosis is the most frequent form of secondary osteoporosis caused by chronic exposure to glucocorticoid excess. Pathogenesis of glucocorticoid-induced osteoporosis is multifactorial including direct effects of glucocorticoids on bone cells and indirect effects of glucocorticoids on several neuroendocrine and metabolic pathways. Fragility fractures occur early in glucocorticoid-induced osteoporosis and anti-osteoporotic drugs along with calcium and vitamin D should be started soon after exposure to glucocorticoid excess. This paper summarizes some of the main topics discussed during the 9th Glucocorticoid-Induced Osteoporosis Meeting (Rome, April 2016) with a specific focus on the role of growth hormone/insulin-like growth factor-1 and parathyroid hormone/vitamin D axes in the pathogenesis of glucocorticoid-induced osteoporosis and the controversial aspects concerning therapeutic approach to skeletal fragility in this clinical setting.

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Funding

This study was not funded by any grant

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Authors and Affiliations

  1. Chair of Endocrinology, University of Brescia, Brescia, Italy

    Gherardo Mazziotti, Anna Maria Formenti & Andrea Giustina

  2. McGuire Veterans Affairs Medical Center, Virginia Commonwealth University School of Medicine Richmond, Virginia, USA

    Robert A. Adler

  3. Department of Medicine Columbia University College of Physicians and Surgeons, New York, NY, USA

    John P. Bilezikian

  4. Department of Endocrinology, Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, University of Oxford, Oxford, OX3 7LE, UK

    Ashley Grossman & Emilia Sbardella

  5. Department of Internal Medicine and Medical Disciplines “Sapienza” Rome University, Rome, Italy

    Salvatore Minisola

Authors
  1. Gherardo Mazziotti
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  2. Anna Maria Formenti
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  3. Robert A. Adler
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  4. John P. Bilezikian
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  5. Ashley Grossman
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  6. Emilia Sbardella
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  7. Salvatore Minisola
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  8. Andrea Giustina
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Corresponding author

Correspondence to Andrea Giustina.

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Conflict of interest

G.M. received lecture fee from Abiogen Pharma SpA, J.P.B. was consultant for Merck, Amgen, Radius and received Research Grant from Shire Pharmaceuticals, A.Gr. received lecture fees and Advisory Board payments from Novartis, Ipsen and HRA Pharma, S.M. received lecture fees from Abiogen Pharma SpA, Amgen, Diasorin, Eli Lilly, Italfarmaco, Fujii, Merck Sharp & Dohme, Takeda and Advisory Board payments from Amgen and Eli Lilly, A.Gi. was consultant for Abiogen Pharma SpA. A.M.F., R.A.A. and E.S. declare that they have no conflict of interest.

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Mazziotti, G., Formenti, A.M., Adler, R.A. et al. Glucocorticoid-induced osteoporosis: pathophysiological role of GH/IGF-I and PTH/VITAMIN D axes, treatment options and guidelines. Endocrine 54, 603–611 (2016). https://doi.org/10.1007/s12020-016-1146-8

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  • DOI: https://doi.org/10.1007/s12020-016-1146-8

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