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New Guidelines for Preventing Steroid-Induced Bone Loss: What Patients Need to Know
Published: Jan 18, 2024
The American College of Rheumatology has updated its guidelines for preventing and treating steroid-induced osteoporosis. These new recommendations aim to protect more people from the bone-weakening effects of glucocorticoid medications.
Who Needs Treatment?
The guidelines now recommend bone-protecting treatment for more people taking steroids. This includes adults over 40 at moderate to high risk of fractures, even if they're on low doses of steroids. Risk is assessed using factors like age, steroid dose, and bone density scans. The guidelines also address younger adults and children, emphasizing the importance of early prevention.
Treatment Options
Bisphosphonates remain the first-choice medication for most people. However, the guidelines now suggest considering teriparatide or denosumab for those at very high fracture risk. Calcium and vitamin D supplements are recommended for almost everyone on long-term steroids. Lifestyle changes like exercise and fall prevention are also emphasized.
Monitoring and Follow-up
The guidelines stress the importance of regular bone density scans to track bone health. They also recommend reassessing fracture risk annually for people on long-term steroid therapy. This allows doctors to adjust treatment as needed. The guidelines emphasize a personalized approach, recognizing that each patient's situation is unique.
Frequently Asked Questions
Yes, but the risk is lower than with oral steroids.
Treatment may not be needed, but discuss your individual risk with your doctor.
They're widely respected, but some countries have their own similar guidelines.
Proactive Protection
These updated guidelines aim to prevent more fractures by identifying and treating at-risk patients early.
References
- Humphrey MB, et al. 2022 American College of Rheumatology Guideline for the Prevention and Treatment of Glucocorticoid-Induced Osteoporosis. Arthritis Care Res (Hoboken) 2023; 75:2405.
- Buckley L, et al. 2017 American College of Rheumatology Guideline for the Prevention and Treatment of Glucocorticoid-Induced Osteoporosis. Arthritis Care Res (Hoboken) 2017; 69:1095.
This article has been reviewed for accuracy by one of the licensed medical doctors working for Doctronic. Always discuss health information with your healthcare provider.
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