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Glucocorticoid-induced osteoporosis: presentation and comments on the new American College of Rheumatology guidelines

https://doi.org/10.14341/osteo20173114-120

Abstract

The article presents a review of the clinical guidelines of 2017 American College of Rheumatology for prevention and treatment of glucocorticoid-induced osteoporosis. The guidelines i contain fracture risk gradation not only for people over 40 years , based on the measurement of bone mineral density, 10-year probability of fractures by FRAX and prior osteoporotic fractures, but also for people under 40 years. The guidelines present , recommendations for initial and follow-up treatment for prevention of glucocorticoid-induced osteoporosis according the level of risk of fractures in different age groups of adults, and in children from 4 years of age, in patients with organ transplant and patients older than 30 years, receiving very high-dose of glucocorticoids . Oral bisphosphonates were recommended as first line treatment due to safety, cost, and because of lack of evidence for superior antifracture benefits from other OP medications. Oral bisohosphonates could be switched to another medication in case of intolerance. The issues of applicability of these recommendations in national clinical practice are being discussed.

About the Author

Natalia V. Toroptsova

Research Institute of Rheumatology named after V.A. Nasonova


Russian Federation

MD, PhD, head of osteoporosis laboratory



References

1. van Staa TP, Leufkens HGM, Abenhaim L, et al. Oral corticosteroids and fracture risk: relationship to daily and cumulative doses. Rheumatology (Oxford). 2000;39(12):1383-1389. doi: 10.1093/rheumatology/39.12.1383

2. van Staa TP, Geusens P, Pols HA, et al. A simple score for estimating the long-term risk of fracture in patients using oral glucocorticoids. QJM. 2005;98(3):191-198. doi: 10.1093/qjmed/hci029

3. Curtis JR, Westfall AO, Allison JJ, et al. Longitudinal patterns in the prevention of osteoporosis in glucocorticoid-treated patients. Arthritis Rheum. 2005;52(8):2485-2494. doi: 10.1002/art.21194

4. Баранова И.А., Ершова О.Б., Анаев Э.Х., и др. Анализ оказания консультативной медицинской помощи пациентам с глюкокортикоидным остеопорозом или риском его развития по данным анкетирования пациентов (исследование ГЛЮКОСТ). // Терапевтический архив. – 2015. – Т. 87. – №5. – С. 58-64. [Baranova IA, Ershova OB, Anaev EK, et al. Analysis of the state-of-the-art of consulting medical care to patients with glucocorticoid-induced osteoporosis or its risk according to the data of a questionnaire survey (GLUCOST study). Ter Arkh.2015;87(5):58-64. (In Russ.)] doi: 10.17116/terarkh201587558-64

5. Buckley L, Guyatt G, Fink HA, et al. 2017 American College of Rheumatology Guideline for the Prevention and Treatment of Glucocorticoid-Induced Osteoporosis. Arthritis Rheumatol. 2017;69(8):1521-1537. doi: 10.1002/art.40137

6. Dawson-Hughes B, Tosteson AN, Melton LJ, 3rd, et al. Implications of absolute fracture risk assessment for osteoporosis practice guidelines in the USA. Osteoporos Int. 2008;19(4):449-458. doi: 10.1007/s00198-008-0559-5

7. Kanis JA, Johansson H, Oden A, McCloskey EV. Guidance for the adjustment of FRAX according to the dose of glucocorticoids. Osteoporos Int. 2011;22(3):809-816. doi: 10.1007/s00198-010-1524-7

8. Баранова И.А., Торопцова Н.В., Лесняк О.М. Основные положения клинических рекомендаций «Диагностика, профилактика и лечение глюкокортикоидного остеопороза у мужчин и женщин 18 лет и старше». // Остеопороз и остеопатии. – 2014. – Т. 17. – №3. – C. 34-37. [Baranova IA, Toroptsova NV, Lesnyak OM. The Main Provisions of the Guidelines «Diagnosis, Prevention and Treatment of Glucocorticoid Osteoporosis in Men and Women 18 Years and Older». Osteoporosis and bone diseases. 2014;17(3):34-37. (In Russ.)] doi: 10.14341/osteo2014334-37

9. Белая Ж.Е., Белова К.Ю., Бордакова Е.В., и др. Профилактика, диагностика и лечение дефицита витамина D и кальция среди взрослого населения и у пациентов с остеопорозом. В кн.: Рекомендации Российской ассоциации по остеопорозу. / Под ред. Лесняк О.М. – М.: ГЭОТАР-Медиа; 2016. [Belaya ZE, Belova KY, Bordakova EV, et al. Profilaktika, diagnostika i lechenie defitsita vitamina D i kal'tsiya sredi vzroslogo naseleniya i u patsientov s osteoporozom. In: Lesnyak OM, editor. Rekomendatsii Rossiyskoy assotsiatsii po osteoporozu. Moscow: GEOTAR-Media; 2016. (In Russ.)]

10. Kanis JA, McCloskey EV, Johansson H, et al. Development and use of FRAX in osteoporosis. Osteoporos Int. 2010;21 Suppl 2:S407-413. doi: 10.1007/s00198-010-1253-y

11. de Nijs RN, Jacobs JW, Algra A, et al. Prevention and treatment of glucocorticoid-induced osteoporosis with active vitamin D3 analogues: a review with meta-analysis of randomized controlled trials including organ transplantation studies. Osteoporos Int. 2004;15(8):589-602. doi: 10.1007/s00198-004-1614-5

12. Amiche MA, Albaum JM, Tadrous M, et al. Efficacy of osteoporosis pharmacotherapies in preventing fracture among oral glucocorticoid users: a network meta-analysis. Osteoporos Int. 2016;27(6):1989-1998. doi: 10.1007/s00198-015-3476-4


Supplementary files

Review

For citations:


Toroptsova N.V. Glucocorticoid-induced osteoporosis: presentation and comments on the new American College of Rheumatology guidelines. Osteoporosis and Bone Diseases. 2017;20(3):114-120. (In Russ.) https://doi.org/10.14341/osteo20173114-120

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ISSN 2072-2680 (Print)
ISSN 2311-0716 (Online)