How to prevent steroid induced osteoporosis

Sambrook, Philip N.

doi:10.1136/ard.2003.018556

Cited by 75 publications

(44 citation statements)

References 15 publications

(7 reference statements)

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“…Guidelines recommend osteoporosis prevention when corticosteroids are used, an issue often forgotten in practice. Supplementation with calcium and vitamin D 51,52 On the contrary, proton pump inhibitors are not routinely indicated when corticosteroids are used without NSAIDs. 53 A very low tapering only after stable remission with symptom resolution and normalization of CRP is the key to successful management of the disease, similar to what is often done in polymyalgia rheumatica.…”

Section: Antiinflammatory Therapy Corticosteroidsmentioning

confidence: 99%

Controversial Issues in the Management of Pericardial Diseases

Spodick²,

et al. 2010

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Section: Antiinflammatory Therapy Corticosteroidsmentioning

confidence: 99%

Controversial Issues in the Management of Pericardial Diseases

Spodick²,

et al. 2010

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“…Even for those patients who respond to the conventional treatment regimens of systemic corticosteroid and immunosuppressives, the side effects these patients encountered could be very substantial. 38 Many patients developed steroid-induced diabetes, osteoporosis, pathologic fracture of bones, and serious infections. 39,40 For these reasons, treatment options alternative to systemic corticosteroid and immunosuppressives are always sought by clinicians who care for this group of patients.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness and side effects of anti-CD20 therapy for autoantibody-mediated blistering skin diseases: A comprehensive survey of 71 consecutive patients from the Initial use to 2007

Peterson

Chan

2008

TCRM

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Abstract:In order to examine the effi cacy and side effects of the monoclonal antibody anti-CD20 (rituximab) on autoimmune blistering skin diseases, we performed a comprehensive survey of 71 consecutive patients from initial use up to 2007, using the PubMed database. A heterogeneous group of patients, including 51 patients with pemphigus vulgaris, one with pemphigus vegetans, nine with pemphigus foliaceus, fi ve with paraneoplastic pemphigus, four with epidermolysis bullosa acquisita, and one with both bullous pemphigoid and graft vs host disease was included in this survey. Overall the monoclonal antibody seems to be effective in that 69% of patients showed complete response, 25% of patients showed partial response, whereas 6% of patients showed progressive disease. Six deaths occurred in association with the treatment, with four of these deaths in patients with paraneoplastic pemphigus, a disease characteristically resistant to conventional medication and with a high mortality rate. Of note, 11 patients who received combined rituximab and intravenous immune globulin treatments had the best outcome: complete response without any serious side effects. Therefore further investigation on rituximab with controlled clinical trial is a worthy pursuit.

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“…Alendronate (Fosamax) is approved in USA for use in men and has been shown to increase BMD with a trend toward reduction of non-vertebral and vertebral fracture risk [96]. Risedronate (Actonel] is often used in men with chronic steroid use and it has been shown to increase BMD in men as well [97,98].…”

Section: Bisphosphonatesmentioning

confidence: 99%

Low Testosterone—An Important Predictor of Low Mineral Bone Density in Young Men—Our Own Experience and a Review of Literature

Funaro¹,

Bolyakov²,

Gimenez³

et al. 2013

ASM

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Urologists and reproductive endocrinologists have become the first contact physicians for young men of reproductive age and have the unique opportunity to positively affect men's health and quality of life. Growing evidence indicates that a significant proportion of men presenting with infertility or sexual dysfunction are hypogonadal. One hundred ninety nine men were enrolled in our center, and mean total testosterone was <300 ng/dl. Patients were divided into three groups based on their DEXA scan results; normal bone density (n = 122, 57%), osteopenia (n = 69, 39%) and osteoporosis (n = 8, 4%). There were no differences in the mean age (p < 0.64), height (p < 0.99) and weight (p < 0.06) among the three groups (ANOVA), but men with osteopenia had statistically significant lower weights (p < 0.02). Our results indicate that hypogonadism is one of the main risk factors for osteopenia and osteoporosis which can be found in 8% of hypogonadal men younger than 50 years of age. Testosterone replacement therapy may be indicated in most men with hypogonadism and low bone mineral density (BMD); however the benefits of testosterone treatment in eugonadal men are unproven. Selective estradiol and androgen receptor modulators expand our treatment modalities in men of reproductive age when suppression of gonadotropins may interfere with reproductive plans. Early detection of hypogonadism and osteoporosis may lower the risk of hip and vertebral fractures in some men. Further prospective RCTs are needed to prove cost-effectiveness of detection and the best treatment of osteoporosis in hypogonadal men of reproductive age. Urologists have the opportunity to be at the forefront of greater awareness of this clinical problem due to their frequent contact with this population of patients.

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How to prevent steroid induced osteoporosis

Cited by 75 publications

References 15 publications

Controversial Issues in the Management of Pericardial Diseases

Controversial Issues in the Management of Pericardial Diseases

Effectiveness and side effects of anti-CD20 therapy for autoantibody-mediated blistering skin diseases: A comprehensive survey of 71 consecutive patients from the Initial use to 2007

Low Testosterone—An Important Predictor of Low Mineral Bone Density in Young Men—Our Own Experience and a Review of Literature

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