Management of glucocorticoid-induced osteoporosis in rheumatic diseases
Abstract
Glucocorticoid-induced osteoporosis (GIOP) and its attendant fractures are a major concern for patients with rheumatic diseases. This 2025 review highlights preventive and treatment strategies for GIOP. An overview of the epidemiology and pathogenesis of GIOP is discussed. Key questions considered are. (1) What are the optimum risk factor assessment strategies to identify patients with GIOP at fracture risk, including the role of clinical risk factors, imaging modalities and fracture risk calculators? (2). What are the preventive strategies for GIOP incorporating information on steroid-sparing agents for the treatment of rheumatic diseases, the role of calcium and vitamin D intake, and exercise ? (3). What are treatment strategies for GIOP with a focus on clinical trial data for FDA-approved therapies that have been studied in patients with rheumatic diseases? Clinical practice guidelines are discussed. Future directions for the prevention and treatment of GIOP in persons with rheumatic diseases are considered.
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