Endocrinology Book

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Corticosteroid Associated Osteoporosis

Aka: Corticosteroid Associated Osteoporosis, Osteoporosis Secondary to Corticosteroid Use
  1. See Also
    1. Systemic Corticosteroid
    2. Osteoporosis
  2. Risk Factors: Osteoporosis on long-term Corticosteroids
    1. Prednisone 1-5 mg: Relative Risk 1.9x
    2. Prednisone 5-10 mg: Relative Risk 4.5x
    3. Prednisone >10 mg: Relative Risk 32x
  3. Evaluation: Obtain Bone Mineral Density
    1. Check BMD at baseline prior to therapy
    2. Check BMD every 6-12 months during first 2 years
  4. Prevention: Osteoporosis from long-term steroids
    1. Use lowest dose of a short-acting glucocorticoid
    2. Maintain a well-balanced, low Sodium diet (2-3 gram)
    3. Weight bearing Exercise and Isometric Exercise
    4. Calcium Supplementation 1500 mg/day
    5. Vitamin D Supplementation 400-800 IU/day
    6. Control Hypercalciuria with Thiazide Diuretics
    7. Treat Hypogonadism
      1. Menopause: Hormone Replacement Therapy
      2. Men with low testosterone: Testosterone Replacement
    8. Treat bone loss if it occurs with Corticosteroid use
      1. Hormone Replacement Therapy
      2. Bisphosphonates
      3. Calcitonin
  5. References
    1. Dubois (2002) Chest 121:1456-63 [PubMed]
    2. Lane (1998) Endocrinol Metab Clin North Am 27:465-83 [PubMed]

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