Mesh : Bone Density Bone Density Conservation Agents / therapeutic use Cholecalciferol / therapeutic use Diphosphonates / therapeutic use Evidence-Based Medicine Fractures, Bone / etiology prevention & control Glucocorticoids / administration & dosage adverse effects Humans Japan Osteoporosis / chemically induced complications drug therapy prevention & control Practice Guidelines as Topic Prednisolone / administration & dosage adverse effects Time Factors Vitamin K 2 / therapeutic use

来  源:   DOI:CliCa061117881796

Abstract:
Osteoporosis is the most frequent adverse effect of glucocorticoids. Management guidelines for glucocorticoid-induced osteoporosis have been established in the United States, the United Kingdom, and many other countries. The 2004 edition of the guidelines on the management and treatment of glucocorticoid-induced osteoporosis have been proposed by The Japanese Society for Bone and Mineral Research. The subjects were patients with using or planning to use oral glucocorticoids for 3 months or longer. The criterion for starting treatment was patients with prior fragility fracture and with new fractures during treatment, patients with less bone mineral density (BMD) than 80% of young adult mean, and patients with using as a dose of 5mg/day or higher (mean daily dose) as prednisolone equivalent. The bisphosphonates have been recommended as first-line drugs and active vitamin D(3) and vitamin K(2) have been recommended as second-line drugs.
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