دورية أكاديمية
Prevention and Treatment of Glucocorticoid-Induced Osteoporosis in Adults: Consensus Recommendations From the Belgian Bone Club.
| العنوان: | Prevention and Treatment of Glucocorticoid-Induced Osteoporosis in Adults: Consensus Recommendations From the Belgian Bone Club. |
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| المؤلفون: | Laurent, Michaël R, Goemaere, Stefan, Verroken, Charlotte, Bergmann, Pierre, Body, Jean-Jacques, Bruyère, Olivier, Cavalier, Etienne, Rozenberg, Serge, Lapauw, Bruno, Gielen, Evelien |
| المصدر: | Frontiers in Endocrinology, 13, 908727 (2022) |
| بيانات النشر: | Frontiers Media S.A., 2022. |
| سنة النشر: | 2022 |
| مصطلحات موضوعية: | Cushing syndrome, adults, glucocorticoid-induced osteoporosis, glucocorticoids, osteoporosis, prevention, Glucocorticoids, Calcium, Belgium/epidemiology, Consensus, Glucocorticoids/adverse effects, Humans, Fractures, Bone/etiology, Fractures, Bone/prevention & control, Osteoporosis/chemically induced, Osteoporosis/drug therapy, Endocrinology, Diabetes and Metabolism, Human health sciences, Public health, health care sciences & services, Sciences de la santé humaine, Santé publique, services médicaux & soins de santé |
| الوصف: | Glucocorticoids are effective immunomodulatory drugs used for many inflammatory disorders as well as in transplant recipients. However, both iatrogenic and endogenous glucocorticoid excess are also associated with several side effects including an increased risk of osteoporosis and fractures. Glucocorticoid-induced osteoporosis (GIOP) is a common secondary cause of osteoporosis in adults. Despite availability of clear evidence and international guidelines for the prevention of GIOP, a large treatment gap remains. In this narrative review, the Belgian Bone Club (BBC) updates its 2006 consensus recommendations for the prevention and treatment of GIOP in adults. The pathophysiology of GIOP is multifactorial. The BBC strongly advises non-pharmacological measures including physical exercise, smoking cessation and avoidance of alcohol abuse in all adults at risk for osteoporosis. Glucocorticoids are associated with impaired intestinal calcium absorption; the BBC therefore strongly recommend sufficient calcium intake and avoidance of vitamin D deficiency. We recommend assessment of fracture risk, taking age, sex, menopausal status, prior fractures, glucocorticoid dose, other clinical risk factors and bone mineral density into account. Placebo-controlled randomized controlled trials have demonstrated the efficacy of alendronate, risedronate, zoledronate, denosumab and teriparatide in GIOP. We suggest monitoring by dual-energy X-ray absorptiometry (DXA) and vertebral fracture identification one year after glucocorticoid initiation. The trabecular bone score might be considered during DXA monitoring. Extended femur scans might be considered at the time of DXA imaging in glucocorticoid users on long-term (≥ 3 years) antiresorptive therapy. Bone turnover markers may be considered for monitoring treatment with anti-resorptive or osteoanabolic drugs in GIOP. Although the pathophysiology of solid organ and hematopoietic stem cell transplantation-induced osteoporosis extends beyond GIOP alone, the BBC recommends similar evaluation, prevention, treatment and follow-up principles in these patients. Efforts to close the treatment gap in GIOP and implement available effective fracture prevention strategies into clinical practice in primary, secondary and tertiary care are urgently needed. |
| نوع الوثيقة: | journal article http://purl.org/coar/resource_type/c_6501 article |
| اللغة: | English |
| Relation: | https://www.frontiersin.org/articles/10.3389/fendo.2022.908727/full; urn:issn:1664-2392 |
| DOI: | 10.3389/fendo.2022.908727 |
| URL الوصول: | https://orbi.uliege.be/handle/2268/293443 |
| حقوق: | open access http://purl.org/coar/access_right/c_abf2 info:eu-repo/semantics/openAccess |
| رقم الأكسشن: | edsorb.293443 |
| قاعدة البيانات: | ORBi |
| DOI: | 10.3389/fendo.2022.908727 |
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