Abstract
Glucocorticoid-induced osteoporosis (GIOP) is a common cause of secondary osteoporosis. The highest rate of bone loss occurs within the first 3–6 months of glucocorticoid treatment. Direct effects of glucocorticoids on bone include an early, transient increase in bone resorption and long-term suppression of bone formation. The risk of fractures is directly proportional to the duration and dosage of glucocorticoids taken. It is necessary to assess and reassess the risks of osteoporotic fractures in time and prevent their occurrence. Densitometry should be performed in patients under the age of 40 years 6 months after the start of corticosteroid therapy. For patients older than 40 years FRAX should be considered. When treating osteoporosis, it is important to take into account such factors as the age of the patient, the history of fractures or osteoporosis, the duration of administration and cumulative dosage of glucocorticoids, concomitant diseases, the risk of fracture, etc. Bisphosphonates are the first-line treatment option for the prevention of fracture in patients receiving glucocorticoids. If oral bisphosphonates are ineffective, intravenous bisphosphonates are used for treatment. Teriparatide and denosumab are considered as second-line drugs. It is also important to educate patients to lead a healthy lifestyle.
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