Therapies for Preventing Bone Loss with Glucocorticoid Treatment.
Arnav AgarwalJonathan D AdachiPublished in: Current osteoporosis reports (2021)
Lifestyle optimization remains the hallmark of bone health preservation. Early initiation of anti-osteoporotic agents in the setting of glucocorticoid exposure is essential, guided by appropriate risk stratification. Recommendations for calcium and vitamin D intake optimization are well-supported across all risk strata. Bisphosphonates are the mainstay of pharmacological therapy. Newer agents such as denosumab and teriparatide have demonstrated comparative benefit in terms of incident fracture risk reduction and bone mineral density preservation, with comparable adverse events. With due consideration to cost, resource availability, and patient values and preferences, these agents may warrant use as the first-line agents in this setting. Glucocorticoid-induced osteoporosis remains preventable and warrants early and targeted evidence-based therapy.
Keyphrases
- bone mineral density
- postmenopausal women
- body composition
- bone loss
- cardiovascular disease
- healthcare
- metabolic syndrome
- physical activity
- mental health
- bone marrow
- drug induced
- cancer therapy
- clinical practice
- oxidative stress
- replacement therapy
- combination therapy
- health promotion
- soft tissue
- human health
- chemotherapy induced