Glucocorticoid-induced osteoporosis

Glucocorticoid-induced osteoporosis (GIOP) is a challenging problem. Several rheumatic disorders necessitate long-term glucocorticoid therapy. Therefore, it is a topic of great interest to practicing rheumatologists. During the first 6–12 months of glucocorticoid therapy there is an initial loss of 3–27% of bone mineral density (BMD). It is estimated that 50% of chronic glucocorticoid users will develop bone loss leading to fracture, especially of spine and neck of femur. For a given BMD, the risk of fracture is higher in GIOP than in postmenopausal osteoporosis. American College of Rheumatology has laid down guidelines for the prevention and treatment of GIOP. Various facts and current therapies aimed at its prevention and reversal are discussed in this review article.