Abstract
Clinical and experimental data have shown that prolonged exposure to GCs leads to bone loss and increases fracture risk. Special attention has been given to existing emerging drugs that can prevent and treat glucocorticoid-induced osteoporosis GIOP. However, there is no consensus about the most relevant animal model treatments on GIOP. In this systematic review, we aimed to examine animal models of GIOP centering on study design, drug dose, timing and size of the experimental groups, allocation concealment, and outcome measures. The present review was written according to the PRISMA 2020 statement. Literature searches were performed in the PubMed electronic database via Mesh with the publication date set between April, 2011, and February 2021. A total of 284 full-text articles were screened and 53 were analyzed. The most common animal species used to model GIOP were rats (66%) and mice (32%). In mice studies, males (58%) were preferred and genetically modified animals accounted for 28%. Our work calls for a standardization of the establishment of the GIOP animal model with better precision for model selection. A described reporting design, conduction, and selection of outcome measures are recommended.
Highlights
IntroductionGlucocorticoids (GCs) continue to be prescribed in many diseases because of their immunomodulatory capacities
Despite their side effects, glucocorticoids (GCs) continue to be prescribed in many diseases because of their immunomodulatory capacities
We focused on papers that measure, on one hand, the bone loss with either (dual-energy X-ray absorptiometry (DXA) or microtomography, and on the other hand, biomechanical properties to characterize the Glucocorticoid induced osteoporosis (GIOP) bone phenotype
Summary
Glucocorticoids (GCs) continue to be prescribed in many diseases because of their immunomodulatory capacities. Therapy with long-term GCs leads to deleterious effects due to their systemic impact on the metabolism including cardiovascular, endocrine, dermatologic, muscular, and skeletal effects including bone fragility and aseptic osteonecrosis [1]. In patients with chronic corticosteroid therapy, the annual incidence rate of vertebral fractures was 3.2% (95% CI: 1.8–5) and 5.1% (95% CI: 2.8–8.2) in patients initiating treatment [3]. An increased risk of fragility fracture may be observed within the first three months of treatment [3,4]. Most often asymptomatic, may occur soon after exposure to GCs when bone mineral density (BMD) is rapidly decreasing [5]. Vertebral fractures are associated with GIOP, the risk of hip fractures is increased [2,4]
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