Treatment options for glucocorticoid-induced osteoporosis.
Iacopo ChiodiniDaniela MerlottiAlberto FalchettiLuigi GennariPublished in: Expert opinion on pharmacotherapy (2020)
Despite the widespread use of GCs and their well-established detrimental skeletal effects, GIOP remains an under-diagnosed and under-treated condition. Indeed, the clinical management of GIOP is still debated, so that the recent guidelines differ in their indications for pharmacological intervention. Either bone mineral density (BMD) or algorithms such as FRAX do not completely account for the remarkable and rapid increase in fracture risk of most GC-treated patients. Moreover, while oral bisphosphonates remain the most used and cost-effective option, the potential increased benefits of more potent antiresorptive agents (e.g. denosumab and zoledronate) or anabolic compounds (e.g. teriparatide) warrant further investigation. Despite the above limitations, the assessment of fracture risk is recommended for all individuals committed to receiving oral GCs for 3 months or longer.
Keyphrases
- bone mineral density
- postmenopausal women
- body composition
- newly diagnosed
- end stage renal disease
- randomized controlled trial
- ejection fraction
- machine learning
- peritoneal dialysis
- prognostic factors
- high glucose
- deep learning
- risk assessment
- high resolution
- diabetic rats
- patient reported outcomes
- oxidative stress
- climate change
- loop mediated isothermal amplification