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.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
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
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
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
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
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
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
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
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
Gourlay M, Franceschini N, Sheyn Y (2007) Prevention and treatment strategies for glucocorticoid-induced osteoporosis. Clin Rheumatol 26:144–153
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
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
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
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
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
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
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
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
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
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
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
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
Conflicts of interest
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).
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
- Bone mineral density
- Bone protective therapy