Guidelines Updated on Managing Glucocorticoid-Induced Osteoporosis — Physician’s First Watch
Guidelines Updated on Managing Glucocorticoid-Induced Osteoporosis
By Amy Orciari Herman
The American College of Rheumatology has issued updated guidance on managing glucocorticoid-induced osteoporosis in adults and children. Among the recommendations:
For all patients, fracture risk should be assessed within 6 months (or sooner) after starting long-term glucocorticoid treatment. The assessment should include details on the glucocorticoid dosage, fracture history, bone mineral density, comorbidities, height and weight measurement, and for adults aged 40 and older, use of the FRAX tool.
Fracture risk should be reassessed every 12 months during treatment.
All patients should optimize their calcium and vitamin D intake and make lifestyle changes consistent with good bone health (e.g., stop smoking, exercise regularly).
Recommendations on antiresorptive medications are given based on fracture risk. The guidance, freely available in Arthritis and Rheumatism, also includes recommendations for specific populations (e.g., women of childbearing potential, organ transplant recipients).