Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Rheumatology Unit, University of Verona, Verona, Italy.
Curr Opin Rheumatol. 2019 Jul;31(4):388-393. doi: 10.1097/BOR.0000000000000608.
Steroid-induced osteoporosis or glucocorticoid-induced osteoporosis (GIOP) is a common form of secondary osteoporosis and is a cause of increased morbidity and mortality. The pathogenesis of GIOP includes decreased bone formation and increased bone resorption. Clinicians can rely on several effective medications for the treatment and prevention of GIOP, including antiresorptive drugs (i.e. bisphosphonates) and bone anabolic drugs (i.e. teriparatide).
Recent studies have further highlighted that GIOP is a major public health concern and have provided new insights on the pathogenesis of GIOP, in particular, the dose-dependent effects of glucocorticoids on bone. New evidence on the real-world effectiveness of established GIOP therapies have been recently published as well as the results of the 24-months denosumab randomized controlled trial in GIOP.
GIOP and fragility fractures are important adverse events related to the long-term use of glucocorticoids. Recent studies have provided additional data on the epidemiology and pathogenesis of GIOP and on the efficacy and effectiveness of GIOP therapies.
激素诱导性骨质疏松症或糖皮质激素诱导性骨质疏松症（GIOP）是一种常见的继发性骨质疏松症，也是发病率和死亡率增加的原因。GIOP 的发病机制包括成骨减少和破骨增加。临床医生可以依靠几种有效的药物来治疗和预防 GIOP，包括抗吸收药物（如双膦酸盐）和骨合成药物（如特立帕肽）。
最近的研究进一步强调了 GIOP 是一个主要的公共卫生问题，并提供了 GIOP 发病机制的新见解，特别是糖皮质激素对骨骼的剂量依赖性影响。最近还公布了关于既定 GIOP 治疗方法的真实世界疗效的新证据，以及 GIOP 中地舒单抗 24 个月随机对照试验的结果。
GIOP 和脆性骨折是与长期使用糖皮质激素相关的重要不良事件。最近的研究提供了关于 GIOP 的流行病学和发病机制以及 GIOP 治疗方法的疗效和有效性的更多数据。
