Bone safety of low-dose glucocorticoids in rheumatic diseases

Saag, Kenneth G.

doi:10.1111/nyas.12446

Cited by 15Bone health and osteoporosis researchRheumatoid Arthritis Research and TherapiesBone Metabolism and Diseases

Bone safety of low-dose glucocorticoids in rheumatic diseases

Saag, Kenneth G.·2014·Annals of the New York Academy of Sciences

DOI 10.1111/nyas.12446

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Abstract

Glucocorticoids are widely used internationally for the treatment of inflammatory disease, such as rheumatoid arthritis (RA). Although the benefit of glucocorticoids in RA on both disease activity and severity are well known, there remain unanswered questions about the overall bone safety of chronic low-dose glucocorticoids in RA. Debate exists about the merits of glucocorticoids for bone health on the basis of their benefits in promoting activity and reducing proinflammatory cytokines. Overall current evidence supports the view that bone loss is a disease related both to RA and to glucocorticoid use independently. Calcium and vitamin D, along with prescription antiosteoporosis therapies, particularly bisphosphonates and teriparatide, play an important role in stabilizing bone mineral density and potentially lowering spinal fracture risk at the spine. International guidelines provide pathways for appropriate prevention of glucocorticoid-induced osteoporosis (GIOP). Despite the evidence and these guidelines, many patients do not receive adequate management to prevent GIOP.

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The adverse effect of glucocorticoids on cortical bone quality may not correlate with whole bone mass or bone mineral density.
“This finding again suggests the adverse effect of GC on the cortical bone quality may not correlate with whole bone mass or bone mineral density [35, 59].”
From Prevention of glucocorticoid induced bone changes with beta-ecdysone (2015) · cites this paper as [59]

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Authors: Saag, K. G.
Affiliations: University of Alabama at Birmingham (US)
Corresponding author: Saag, Kenneth G.
ORCID: Saag, Kenneth G.
Venue: Annals of the New York Academy of Sciences
Publisher: Wiley
Published: 2014-05
Volume: 1318
Issue: 1
Pages: 55-64
ISSN: 0077-8923 (ISSN-L)
1749-6632
DOI: 10.1111/nyas.12446
OpenAlex: W1938355685
Cited by: 15
References: 108
Citations by year: 2021: 3 · 2020: 1 · 2018: 1 · 2017: 1 · 2016: 3 · 2015: 6
FWCI: 3.45
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor, 8 d)
Locations: Annals of the New York Academy of Sciences (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
Health Sciences › Medicine › Rheumatology › Rheumatoid Arthritis Research and Therapies
Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Bone Metabolism and Diseases
Keywords: glucocorticoids, low-dose glucocorticoids, glucocorticoid-induced osteoporosis, bone mineral density, rheumatoid arthritis, bone loss, osteoporosis prevention, bisphosphonates, teriparatide, calcium and vitamin D
MeSH terms: Arthritis, Rheumatoid, Bone and Bones, Diphosphonates, Glucocorticoids, Humans, Osteoporosis, Prednisolone, Bone Density, Antirheumatic Agents, Bone Density Conservation Agents

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Bone safety of low-dose glucocorticoids in rheumatic diseases

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