Glucocorticoids and Osteoporosis

Overview

Glucocorticoids in therapeutic doses larger than 5 mg prednisone per day administered for more than 3 months cause individually different diminution of bone mass. The basis of steroid osteoporosis is the direct action of glucocorticoids on osteocytes and the indirect effect on intestinal absorption and renal excretion of calcium and the interference with the hormonal control of the calcium and bone metabolism. Glucocorticoids cause in particular diminution of trabecular bone. The diminution can be assessed by DXA or ultrasonodensitometry. The extent of diminution is proportional to the daily dosage and period of administration. After discontinuation of the drog steroid osteoporosis is reversible. Treatment of steroid osteoporosis involves adherence to general principles of treatment of osteoporosis (in particular an adequate intake of calcium and vitamin D, adequate physical activity, optimal lifestyle without smoking and excessive alcohol consumption) and possibly administration of „specific" drugs (hormonal substitution treatment, selective modulators of oestrogen receptors, bisphosphonates, calcitonin, fluorides).

Key words:
glucocorticoids - osteoporosis - bone mass.