Glucocorticoid-induced osteoporosis: skeletal manifestations of glucocorticoid use and 2004 Japanese Society for Bone and Mineral Research-proposed guidelines for its management

Abstract

Glucocorticoid (GC) is widely used to treat a variety of inflammatory and allergic diseases, and about 0.9% of the adult population in Japan (approximately one million people) are known to take oral GC at any given time. GC causes a number of significant side effects, among which are skeletal manifestations such as osteoporosis and degenerative bone fracture, maor complications of GC therapy. Although the population of GC-induced osteoporosis patients is estimated to be approximately one-fifth of patients with primary osteoporosis, few physicians are aware of the increased risk of fracture caused of GC, and there is inadequate information concerning the effetiveness of prevention and treatment of GC-induced osteoporosis. Recently, mechanisms of GC-induced osteoporosis have been clarified, and treatment strategies have been developed. Accordingly, the 2004 Japanese Society for Bone and Mineral Research (JSBMR)-proposed guidelines for the management and treatment of GC-induced osteoporosis have been developed based on the results of a longitudinal study by subcommittee members and the results of an analysis of patients collected by the Subcommittee to Study Diagnostic Criteria for Corticosteroid-induced Osteoporosis, together with evidence obtained overseas and in Japan. The present guideline is prepared for clinical practice.