Management of glucocorticoid-induced osteoporosis

被引：138

作者：

Compston, Juliet ^{[1
]}

机构：

[1] Univ Cambridge, Dept Med, Sch Clin Med, Addenbrookes Hosp, Cambridge CB2 0QQ, England

来源：

NATURE REVIEWS RHEUMATOLOGY | 2010年 / 6卷 / 02期

关键词：

CORTICOSTEROID-INDUCED OSTEOPOROSIS; BONE-MINERAL DENSITY; INTERMITTENT PARATHYROID-HORMONE; VERTEBRAL FRACTURE RISK; DOUBLE-BLIND; INHALED CORTICOSTEROIDS; POSTMENOPAUSAL WOMEN; PRACTICE PATTERNS; PREVENTION; ALENDRONATE;

D O I：

10.1038/nrrheum.2009.259

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Glucocorticoid-induced osteoporosis is a common condition that results in significant morbidity and mortality. The skeletal effects of glucocorticoids include both direct and indirect actions on bone that result in an early, transient increase in bone resorption accompanied by a decrease in bone formation, which is maintained for the duration of glucocorticoid therapy. Rapid bone loss and increased fracture risk occur soon after the initiation of glucocorticoid therapy and are dose dependent. The increase in fracture risk is partly independent of bone mineral density, probably as a result of changes in bone material properties and an increased risk of falling. Bisphosphonates are the front-line choice for prevention of fracture in glucocorticoid-treated patients, with teriparatide as the second-line option; calcium and vitamin D supplements should be co-prescribed in the majority of individuals. Future guidelines for the management of glucocorticoid-induced osteoporosis should recognize the limitations of FRAX (R) in assessing fracture risk in glucocorticoid-treated patients, and should include recently approved interventions, such as zoledronate and teriparatide.

引用

页码：82 / 88

页数：7

共 74 条

[11]

Chappard D, 1996, J BONE MINER RES, V11, P676

[12]

Cohen S, 1999, ARTHRITIS RHEUM, V42, P2309, DOI 10.1002/1529-0131(199911)42:11<2309::AID-ANR8>3.0.CO

[13]

2-K

[14] Recommendations for the registration of agents for prevention and treatment of glucocorticoid-induced osteoporosis: an update from the Group for the Respect of Ethics and Excellence in Science [J].

Compston, J. ;

Reid, D. M. ;

Boisdron, J. ;

Brandi, M. -L. ;

Burlet, N. ;

Cahall, D. ;

Delmas, P. D. ;

Dere, W. ;

Devogelaer, J. -P. ;

Fitzpatrick, L. A. ;

Flamion, B. ;

Goel, N. ;

Korte, S. ;

Laslop, A. ;

Mitlak, B. ;

Ormarsdottir, S. ;

Ringe, J. ;

Rizzoli, R. ;

Tsouderos, Y. ;

Van Staa, T. ;

Reginster, J. -Y. .

OSTEOPOROSIS INTERNATIONAL, 2008, 19 (09) :1247-1250

[15] Guidelines for the diagnosis and management of osteoporosis in postmenopausal women and men from the age of 50 years in the UK [J].

Compston, J. ;

Cooper, A. ;

Cooper, C. ;

Francis, R. ;

Kanis, J. A. ;

Marsh, D. ;

McCloskey, E. V. ;

Reid, D. M. ;

Selby, P. ;

Wilkins, M. .

MATURITAS, 2009, 62 (02) :105-108

[16] Emerging consensus on prevention and treatment of glucocorticoid-induced osteoporosis [J].

Compston J.E. .

Current Rheumatology Reports, 2007, 9 (1) :78-84

[17] Skeletal actions of intermittent parathyroid hormone: Effects on bone remodelling and structure [J].

Compston, Juliet E. .

BONE, 2007, 40 (06) :1447-1452

[18] Longitudinal patterns in the prevention of osteoporosis in glucocorticoid-treated patients [J].

Curtis, JR ;

Westfall, AO ;

Allison, JJ ;

Becker, A ;

Casebeer, L ;

Freeman, A ;

Spettell, CM ;

Weissman, NW ;

Wilke, S ;

Saag, KG .

ARTHRITIS AND RHEUMATISM, 2005, 52 (08) :2485-2494

[19] Alendronate or alfacalcidol in glucocorticoid-induced osteoporosis [J].

de Nijs, Ron N. J. ;

Jacobs, Johannes W. G. ;

Lems, Willem F. ;

Laan, Roland F. J. ;

Algra, Ale ;

Huisman, Anne-Margriet ;

Buskens, Erik ;

de laet, Chris E. D. ;

Oostveen, Ans C. M. ;

Geusens, Piet P. M. M. ;

Bruyn, George A. W. ;

Dijkmans, Ben A. C. ;

Bijlsma, Johannes W. J. .

NEW ENGLAND JOURNAL OF MEDICINE, 2006, 355 (07) :675-684

[20] Fracture risk with intermittent high-dose oral glucocorticoid therapy [J].

de Vries, Frank ;

Bracke, Madelon ;

Leufkens, Hubert G. A. ;

Lammers, Jan-Willem J. ;

Cooper, Cyrus ;

van Staa, Tjeerd P. .

ARTHRITIS AND RHEUMATISM, 2007, 56 (01) :208-214

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