Skip to main content

An appendix to the 2012 IOF–ECTS guidelines for the management of glucocorticoid-induced osteoporosis

Archives of Osteoporosis volume 7, pages 25–30 (2012)Cite this article

Abstract

The use of glucocorticoids in the treatment of medical disorders can lead to rapid bone loss and increased risk of fragility fracture. Updated clinical guidelines are needed that accommodate recent advances in fracture risk assessment and new pharmacological interventions to reduce fracture risk. This document serves as an appendix to the 2012 IOF–ECTS guidelines for the management of glucocorticoid-induced osteoporosis.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

USD 39.95

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

References

  1. Díez-Pérez A, Hooven FH, Adachi JD et al (2011) Regional differences in treatment for osteoporosis. The Global Longitudinal Study of Osteoporosis in Women (GLOW). Bone 49(3):493–498

    PubMed  Article  Google Scholar 

  2. American College of Rheumatology ad hoc Committee on Glucocorticoid-induced Osteoporosis (2001) Recommendations for the prevention and treatment of glucocorticoid-induced osteoporosis: 2001 update. Arthritis Rheum 44:1496–1503

    Article  Google Scholar 

  3. Hoes JN, Jacobs JW, Boers M et al (2007) EULAR evidence-based recommendations on the management of systemic glucocorticoid therapy in rheumatic diseases. Ann Rheum Dis 66:1560–1567

    PubMed  Article  CAS  Google Scholar 

  4. Nawata H, Soen S, Takayanagi R et al (2005) Guidelines on the management and treatment of glucocorticoid-induced osteoporosis of the Japanese Society for Bone and Mineral Research (2004). J Bone Miner Metab 23:105–109

    PubMed  Article  Google Scholar 

  5. Royal College of Physicians (2002) Glucocorticoid-induced osteoporosis. Guidelines on prevention and treatment. Bone and Tooth Society of Great Britain, National Osteoporosis Society and Royal College of Physicians. Royal College of Physicians, London

    Google Scholar 

  6. Brown JP, Josse RG, for the Scientific Advisory Council of the Osteoporosis Society of Canada (2002) Clinical practice guidelines for the diagnosis and management of osteoporosis in Canada. CMAJ 167:S1–S34

    PubMed  Google Scholar 

  7. Devogelaer JP, Goemaere S, Boonen S, Body JJ, Kaufman JM, Reginster JY, Rozenberg S, Boutsen Y (2006) Evidence-based guidelines for the prevention and treatment of glucocorticoid-induced osteoporosis: a consensus document of the Belgian Bone Club. Osteoporos Int 17:8–19

    PubMed  Article  CAS  Google Scholar 

  8. Geusens PP, Lems WF, Verhaar HJ, Leusink G, Goemaere S, Zmierczack H, Compston JE (2006) Review and evaluation of the Dutch guidelines for osteoporosis. J Eval Clin Pract 12:539–548

    PubMed  Article  Google Scholar 

  9. Gourlay M, Franceschini N, Sheyn Y (2007) Prevention and treatment strategies for glucocorticoid-induced osteoporosis. Clin Rheumatol 26:144–153

    PubMed  Article  Google Scholar 

  10. Grossman JM, Gordon R, Ranganath VK et al (2010) American College of Rheumatology 2010 recommendations for the prevention and treatment of glucocorticoid-induced osteoporosis. Arth Care Res 62:1515–1526

    Article  Google Scholar 

  11. Lekamwasam S, Adachi JD, Agnusdei D, et al.; for the Joint IOF-ECTS GIO Guidelines Working Group (2012) A framework for the development of guidelines for the management of glucocorticoid-induced osteoporosis. Osteoporos Int. doi:10.1007/s00198-012-1958-1

  12. Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, McQuay HJ (1996) Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 17:1–12

    PubMed  Article  CAS  Google Scholar 

  13. Hoes JN, Jacobs JW, Hulsmans HM, De Nijs RN, Lems WF, Bruyn GA, Geusens PP, Bijlsma JW (2010) High incidence rate of vertebral fractures during chronic prednisone treatment, in spite of bisphosphonate or alfacalcidol use. Extension of the alendronate or alfacalcidol in glucocorticoid-induced osteoporosis-trial. Clin Exp Rheumatol 28:354–359

    PubMed  Google Scholar 

  14. Stoch SA, Saag KG, Greenwald M, Sebba AI, Cohen S, Verbruggen N, Giezek H, West J, Schnitzer TJ (2009) Once-weekly oral alendronate 70 mg in patients with glucocorticoid-induced bone loss: a 12-month randomized, placebo-controlled clinical trial. J Rheumatol 36:1705–1714

    PubMed  Article  CAS  Google Scholar 

  15. Hozuki T, Imai T, Tsuda E et al (2010) Response of serum carboxylated and undercarboxylated osteocalcin to risedronate monotherapy and combined therapy with vitamin K(2) in corticosteroid-treated patients: a pilot study. Intern Med 49:371–376

    PubMed  Article  CAS  Google Scholar 

  16. Reid DM, Devogelaer JP, Saag K, HORIZON investigators et al (2009) Zoledronic acid and risedronate in the prevention and treatment of glucocorticoid-induced osteoporosis (HORIZON): a multicentre, double-blind, double-dummy, randomised controlled trial. Lancet 373:1253–1263

    PubMed  Article  CAS  Google Scholar 

  17. Burshell AL, Moricke R, Correa-Rotter R, Chen P, Warner MR, Dalsky GP, Taylor KA, Krege JH (2010) Correlations between biochemical markers of bone turnover and bone density responses in patients with glucocorticoid-induced osteoporosis treated with teriparatide or alendronate. Bone 46:935–939

    PubMed  Article  CAS  Google Scholar 

  18. Devogelaer JP, Adler RA, Recknor C, See K, Warner MR, Wong M, Krohn K (2010) Baseline glucocorticoid dose and bone mineral density response with teriparatide or alendronate therapy in patients with glucocorticoid-induced osteoporosis. J Rheumatol 37:141–148

    PubMed  Article  CAS  Google Scholar 

  19. Langdahl BL, Marin F, Shane E, Dobnig H, Zanchetta JR, Maricic M, Krohn K, See K, Warner MR (2009) Teriparatide versus alendronate for treating glucocorticoid-induced osteoporosis: an analysis by gender and menopausal status. Osteoporos Int 20:2095–2104

    PubMed  Article  CAS  Google Scholar 

  20. Saag KG, Zanchetta JR, Devogelaer JP, Adler RA, Eastell R, See K, Krege JH, Krohn K, Warner MR (2009) Effects of teriparatide versus alendronate for treating glucocorticoid-induced osteoporosis: 36-month results of a randomized, double-blind, controlled trial. Arthritis Rheum 60:3346–3355

    PubMed  Article  CAS  Google Scholar 

  21. Saag KG, Shane E, Boonen S, Marín F, Donley DW, Taylor KA, Dalsky GP, Marcus R (2007) Teriparatide or alendronate in glucocorticoid-induced osteoporosis. N Engl J Med 357:2028–2039

    PubMed  Article  CAS  Google Scholar 

Download references

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Centre for Metabolic Bone Diseases, Department of Medicine, Faculty of Medicine, Galle, Sri Lanka

    S. Lekamwasam

  2. Division of Rheumatology, Department of Medicine, McMaster University, Hamilton, Ontario, Canada

    J. D. Adachi

  3. Eli Lilly and Co., Florence, Italy

    D. Agnusdei

  4. Columbia University College of Physicians and Surgeons, New York, USA

    J. Bilezikian

  5. Division of Gerontology and Geriatrics and Center for Musculoskeletal Research, Department of Experimental Medicine, Leuven University, Leuven, Belgium

    S. Boonen

  6. Quantify Research and LIME/MMC, Karolinska Institutet, Stockholm, Sweden

    F. Borgström

  7. MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK

    C. Cooper

  8. NIHR Musculoskeletal Biomedical Research Unit, Institute of Musculoskeletal Sciences, University of Oxford, Oxford, UK

    C. Cooper

  9. Hospital del Mar-IMIM-Universitat Autónoma, Barcelona, Spain

    A. Diez Perez

  10. Academic Unit of Bone Metabolism, University of Sheffield and NIHR Musculoskeletal Biomedical Research Unit, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK

    R. Eastell & E. McCloskey

  11. Division of Endocrinology, Diabetes, and Bone Diseases, Department of Medicine III, Dresden Technical University Medical Center, Dresden, Germany

    L. C. Hofbauer

  12. Centre for Metabolic Bone Diseases (WHO Collaborating Centre), University of Sheffield Medical School, Sheffield, UK

    J. A. Kanis

  13. Department of Endocrinology, Aarhus University Hospital, Aarhus, Denmark

    B. L. Langdahl

  14. Russian Association on Osteoporosis, Yekaterinburg, Russia

    O. Lesnyak

  15. Department of Biochemistry and Experimental Medicine, The Children’s Memorial Health Institute, Warsaw, Poland

    R. Lorenc

  16. Department of Rheumatology, C. Argerich Hospital, Buenos Aires, Argentina

    O. D. Messina

  17. Division of Endocrinology, Campus Bio-Medico University, Rome, Italy

    N. Napoli

  18. Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz, Graz, Austria

    B. Obermayer-Pietsch

  19. Rheumatic Diseases Unit, Molecular Medicine Centre, Institute of Genetics and Molecular Medicine, Western General Hospital, University of Edinburgh, Edinburgh, UK

    S. H. Ralston

  20. University of Sydney-Royal North Shore Hospital, St Leonards, Sydney, Australia

    P. N. Sambrook

  21. Cedars-Sinai/University of California, Los Angeles, USA

    S. Silverman

  22. Bone Metabolic Unit, University of Las Palmas de Gran Canaria, Investigation Group on Osteoporosis, Hospital University Insular, Las Palmas de Gran Canaria, Canary Islands, Spain

    M. Sosa

  23. Institute of Rheumatology, Prague, and Charles University, Faculty of Medicine 1, Prague, Czech Republic

    J. Stepan

  24. Action for Healthy Bones, Graz, Austria

    G. Suppan

  25. International Osteoporosis Foundation, Nyon, Switzerland

    D. A. Wahl

  26. Department of Medicine, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK

    J. E. Compston

Authors
  1. S. Lekamwasam
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J. D. Adachi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. D. Agnusdei
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J. Bilezikian
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. S. Boonen
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. F. Borgström
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. C. Cooper
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. A. Diez Perez
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. R. Eastell
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. L. C. Hofbauer
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. J. A. Kanis
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. B. L. Langdahl
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. O. Lesnyak
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. R. Lorenc
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. E. McCloskey
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. O. D. Messina
    View author publications

    You can also search for this author in PubMed Google Scholar

  17. N. Napoli
    View author publications

    You can also search for this author in PubMed Google Scholar

  18. B. Obermayer-Pietsch
    View author publications

    You can also search for this author in PubMed Google Scholar

  19. S. H. Ralston
    View author publications

    You can also search for this author in PubMed Google Scholar

  20. P. N. Sambrook
    View author publications

    You can also search for this author in PubMed Google Scholar

  21. S. Silverman
    View author publications

    You can also search for this author in PubMed Google Scholar

  22. M. Sosa
    View author publications

    You can also search for this author in PubMed Google Scholar

  23. J. Stepan
    View author publications

    You can also search for this author in PubMed Google Scholar

  24. G. Suppan
    View author publications

    You can also search for this author in PubMed Google Scholar

  25. D. A. Wahl
    View author publications

    You can also search for this author in PubMed Google Scholar

  26. J. E. Compston
    View author publications

    You can also search for this author in PubMed Google Scholar

Consortia

for the Joint IOF–ECTS GIO Guidelines Working Group

Corresponding author

Correspondence to J. E. Compston.

Additional information

The 2012 IOF–ECTS guidelines for the management of glucocorticoid-induced osteoporosis can be found in Osteoporosis International (DOI 10.1007/s00198-012-1958-1).

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Lekamwasam, S., Adachi, J.D., Agnusdei, D. et al. An appendix to the 2012 IOF–ECTS guidelines for the management of glucocorticoid-induced osteoporosis. Arch Osteoporos 7, 25–30 (2012). https://doi.org/10.1007/s11657-012-0070-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11657-012-0070-7

Keywords

  • Glucocorticoids
  • Bone mineral density
  • Fracture
  • FRAX
  • Bone protective therapy