Abstract
Glucocorticoid-induced osteoporosis (GIOP) is a chronic metabolic bone disease, which leads to high morbidity and mortality. In adult patients on chronic glucocorticoid osteoporotic fracture occurs only in 30-50 %.
It seems that in terms of the bone is no safe dose glucocorticoids. Attenuation of bone formation is a key mechanism of GIOP, and also the difference with postmenopausal osteoporosis.
An important risk factor for GIOP daily dose steroids, the total cumulative dose and duration of administration. Supplementation with calcium and vitamin D is absolutely essential condition for the prevention and treatment of GIOP Bisphosphonates are currently the GIOP first choice.
Teriparatide should be the treatment of choice for patients at the highest risk of fractures, and also due to its mechanism of action. The discovery of Wnt signaling pathways great hope in the treatment of GIOP.
Completely new approach to GIOP would mean the development of selective glucocorticoid receptor modulators. Such substances should anti-inflammatory effect without affecting osteoblasts.
Denosumab is a promising drug in the treatment of GIOP in close future