Management of corticosteroid‐induced osteoporosis

Corticosteroid therapy results in osteoporosis. There is a doubling in the risk of fracture in patients taking more than the equivalent of 7.5 mg day-1. The bone loss is most rapid from the axial skeleton, particularly during the 1st year of therapy. The most important mechanism for the bone loss is a decrease in osteoblastic activity. Preventative strategies should be targeted to patients with low bone-mineral density, especially if the dose of corticosteroids is likely to be high. Treatment strategies agreed on by the Consensus Panel included hormone replacement therapy and bisphosphonates, with monitoring of efficacy by bone densitometry.