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Titolo:
Corticosteroid osteoporosis
Autore:
Sambrook, P; Lane, NE;
Indirizzi:
Univ Sydney, Inst Bone & Joint Res, Sydney, NSW 2006, Australia Univ Sydney Sydney NSW Australia 2006 nt Res, Sydney, NSW 2006, Australia Univ Calif San Francisco, Div Rheumatol, San Francisco, CA 94143 USA Univ Calif San Francisco San Francisco CA USA 94143 ancisco, CA 94143 USA
Titolo Testata:
BEST PRACTICE & RESEARCH IN CLINICAL RHEUMATOLOGY
fascicolo: 3, volume: 15, anno: 2001,
pagine: 401 - 413
SICI:
1521-6942(200107)15:3<401:CO>2.0.ZU;2-P
Fonte:
ISI
Lingua:
ENG
Soggetto:
GLUCOCORTICOID-INDUCED OSTEOPOROSIS; LOW-DOSE CORTICOSTEROIDS; BONE-MINERAL DENSITY; INTESTINAL CALCIUM-ABSORPTION; PARATHYROID-HORMONE TREATMENT; CONTROLLED CLINICAL-TRIAL; RHEUMATOID-ARTHRITIS; VERTEBRAL FRACTURE; DOUBLE-BLIND; POLYMYALGIA-RHEUMATICA;
Keywords:
glucocorticoids; fracture; osteoporosis; avascular necrosis; bone mineral density;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
61
Recensione:
Indirizzi per estratti:
Indirizzo: Sambrook, P Univ Sydney, Inst Bone & Joint Res, Sydney, NSW 2006, Australia Univ Sydney Sydney NSW Australia 2006 ey, NSW 2006, Australia
Citazione:
P. Sambrook e N.E. Lane, "Corticosteroid osteoporosis", BEST PR R C, 15(3), 2001, pp. 401-413

Abstract

Corticosteroids are widely used and effective agents for the control of many inflammatory diseases, but corticosteroid osteoporosis is a common problem associated with their long term high dose use. Prevention of corticosteroid osteoporosis is preferable to treatment of established corticosteroid bone loss. Several large double-blind controlled clinical trials in patients with corticosteroid osteoporosis have recently been published that provide new insights into its treatment. Based upon available evidence, the rank order of choice for prophylaxis would be a bisphosphonate followed by a vitamin D metabolite or an oestrogen type medication. Calcium alone appears to be unableto prevent rapid bone loss in patients starting corticosteroids, especially with prednisolone doses at 10 mg a day or greater. If an active vitamin Dmetabolite is used, calcium supplementation should be avoided unless dietary calcium intake is low. Hormone replacement therapy should be considered if hypogonadism is present. Since vertebral fracture is a common and important complication of high dose corticosteroid therapy, these findings suggest that rapid bone loss and hence fractures, can be prevented by prophylactic treatment. Although the follow-up data is limited, it is likely that suchtherapy needs to be continued beyond 12 months whilst patients continue significant doses of corticosteroid therapy.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 07/04/20 alle ore 23:07:21