Glucocorticoid-induced osteoporosis and osteonecrosis

Endocrinol Metab Clin North Am. 2012 Sep;41(3):595-611. doi: 10.1016/j.ecl.2012.04.004. Epub 2012 May 23.

Abstract

Glucocorticoid administration is the most common cause of secondary osteoporosis and the leading cause of nontraumatic osteonecrosis. In patients receiving long-term therapy, glucocorticoids induce fractures in 30% to 50% and osteonecrosis in 9% to 40%. This article reviews glucocorticoid-induced osteoporosis and osteonecrosis, addressing the risk factors, pathogenesis, evaluation, treatment, and uncertainties in the clinical management of these disorders.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Review

MeSH terms

  • Antibodies, Monoclonal, Humanized / pharmacology
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Apoptosis / drug effects
  • Bone Density Conservation Agents / pharmacology
  • Bone Density Conservation Agents / therapeutic use
  • Bone and Bones / drug effects*
  • Bone and Bones / metabolism
  • Denosumab
  • Diphosphonates / pharmacology
  • Diphosphonates / therapeutic use
  • Drug Monitoring
  • Female
  • Glucocorticoids / adverse effects*
  • Humans
  • Male
  • Osteoblasts / drug effects
  • Osteoblasts / metabolism
  • Osteocytes / drug effects
  • Osteocytes / metabolism
  • Osteonecrosis / chemically induced*
  • Osteonecrosis / drug therapy
  • Osteonecrosis / physiopathology
  • Osteoporosis / chemically induced*
  • Osteoporosis / drug therapy
  • Osteoporosis / physiopathology
  • Osteoporotic Fractures / etiology
  • Osteoporotic Fractures / prevention & control
  • Teriparatide / pharmacology
  • Teriparatide / therapeutic use

Substances

  • Antibodies, Monoclonal, Humanized
  • Bone Density Conservation Agents
  • Diphosphonates
  • Glucocorticoids
  • Teriparatide
  • Denosumab