[Glucocorticoid and Bone. The changes of Japanese and foreign guidelines for the management of glucocorticoid-induced osteoporosis].

The American College of Rheumatology (ACR) developed recommendations for the prevention and treatment of glucocorticoid- induced osteoporosis (GIO) in 1996. As the beneficial effects of bisphosphonates on GIO were reported from 1997 to 1999, guidelines for the management of GIO were also published from the United Kingdom, Canada, and Australia. In Japan, the Japanese Society for Bone and Mineral Research released guidelines on the management and treatment of GIO in 2005. An approach trying to determine the pharmacological intervention threshold based on assessment of the absolute risk of fractures was initiated in the mid-2000s and FRAX®, a WHO-supported, computer-based, fracture risk assessment was published in 2007. Regarding pharmacological intervention, the efficacy of teriparatide for the treatment of GIO was reported from 2007 to 2009. Based on such new evidence regarding GIO, the ACR recommendation was updated to incorporate FRAX® as an assessment tool for fracture risk in the 2010 revision. The Joint GIO Guidelines Working Group of the International Osteoporosis Foundation and the European Calcified Tissue Society has also published a framework for the development of guidelines for the management of GIO.