Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • News & Views
  • Published:

Bone

The conundrum of glucocorticoid-induced osteoporosis

The incidence of osteoporosis induced by glucocorticoid treatment is second only to that owing to oestrogen deficiency. Treatment and prevention of glucocorticoid-induced osteoporosis are, however, problematic. Can a new framework for the development of national guidelines help steer the diagnosis and management of glucocorticoid-induced osteoporosis towards calmer seas?

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

Relevant articles

Open Access articles citing this article.

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

References

  1. Grossman, J. M. et al. American College of Rheumatology 2010 recommendations for the prevention and treatment of glucocorticoid-induced osteoporosis. Arthritis Care Res. 62, 1515–1526 (2010).

    Article  Google Scholar 

  2. Lekamwasam, S. et al. A framework for the development of guidelines for the management of glucocorticoid-induced osteoporosis. Osteoporos. Int. http://dx.doi.org/10.1007/s00198-012-1958-1.

  3. Adachi, J. D. et al. Two-year effects of alendronate on bone mineral density and vertebral fracture in patients receiving glucocorticoids: a randomized, double-blind, placebo-controlled extension trial. Arthritis Rheum. 44, 202–211 (2001).

    Article  CAS  Google Scholar 

  4. Weinstein, R. S., Jilka, R. L., Parfitt, A. M. & Manolagas, S. C. Inhibition of osteoblastogenesis and promotion of apoptosis of osteoblasts and osteocytes by glucocorticoids. Potential mechanisms of their deleterious effects on bone. J. Clin. Invest. 102, 274–282 (1998).

    Article  CAS  Google Scholar 

  5. Kim, H. J. et al. Glucocorticoids suppress bone formation via the osteoclast. J. Clin. Invest. 116, 2152–2160 (2006).

    Article  CAS  Google Scholar 

  6. Mazziotti, G., Angeli, A., Bilezikian, J. P., Canalis, E. & Giustina, A. Glucocorticoid-induced osteoporosis: an update. Trends Endocrinol. Metab. 17, 144–149 (2006).

    Article  CAS  Google Scholar 

  7. Xiong, J. et al. Matrix-embedded cells control osteoclast formation. Nat. Med. 17, 1235–1241 (2011).

    Article  CAS  Google Scholar 

  8. Van Staa, T. P. et al. Bone density threshold and other predictors of vertebral fracture in patients receiving oral glucocorticoid therapy. Arthritis Rheum. 48, 3224–3229 (2003).

    Article  CAS  Google Scholar 

  9. Teitelbaum, S. L., Seton, M. P. & Saag, K. G. Should bisphosphonates be used for long-term treatment of glucocorticoid-induced osteoporosis? Arthritis Rheum. 63, 325–328 (2011).

    Article  CAS  Google Scholar 

  10. Saag, K. G. et al. Teriparatide or alendronate in glucocorticoid-induced osteoporosis. N. Engl. J. Med. 357, 2028–2039 (2007).

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Ethics declarations

Competing interests

The author declares no competing financial interests.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Teitelbaum, S. The conundrum of glucocorticoid-induced osteoporosis. Nat Rev Endocrinol 8, 451–452 (2012). https://doi.org/10.1038/nrendo.2012.89

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/nrendo.2012.89

This article is cited by

Search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing