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Glucocorticoid-induced osteoporosis (GIO) 

Glucocorticoid-induced osteoporosis (GIO)
Glucocorticoid-induced osteoporosis (GIO)

Gavin Clunie

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date: 28 January 2021

Glucocorticoid (GC) use is common. In a multinational observational study, up to 5% of post-menopausal women, who had visited their family doctor in the previous 2 years, were taking GCs.

GCs adversely affect bone turnover, mass, strength, and fracture risk, both directly and indirectly influencing sex hormone and calcium and vitamin D biochemistry.

Between 30 and 50% of patients on long-term GC therapy suffer severe fractures.

The major direct effect of GCs on bone is on osteoblast proliferation and function.

For patients taking GCs, osteoporotic fracture risk is: proportional to dose and duration of therapy; identifiable within 3 months of starting therapy; associated with a higher BMD, compared with non-GC-treated patients; and is relevant, even at low doses of GCs (e.g. 2.5 mg prednisolone daily).

Screening of patients on GCs for osteoporosis risk and adherence to guidelines for GIO is repeatedly reported as being suboptimal.

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