Littérature scientifique sur le sujet « Glucocorticoids, rheumatic diseases, osteoporosis, fractures »
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Articles de revues sur le sujet "Glucocorticoids, rheumatic diseases, osteoporosis, fractures"
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Evstigneeva, L. P. « Osteoporosis in rheumatic diseases ». Medical alphabet, no 33 (13 décembre 2021) : 64–75. http://dx.doi.org/10.33667/2078-5631-2021-33-64-75.
Texte intégralRésumé :
The article presents a review of studies that have examined osteoporosis in rheumatic diseases, including rheumatoid arthritis, spondylarthritis, psoriatic arthritis, systemic connective tissue diseases, and systemic vasculitis. The review discusses the pathogenesis, diagnosis and treatment of osteoporosis in these diseases, presents the results of epidemiological studies assessing the risk factors and the prevalence of osteoporosis in rheumatic diseases. There was a high prevalence of osteoporosis and fractures in rheumatic diseases, exceeding the population, associated primarily with systemic and local inflammation, as well as with the intake of glucocorticoids. It is indicated that the existing strategies for the treatment of rheumatic diseases may partially reduce bone loss, but long-term administration of glucocorticoids, on the contrary, increase bone resorption. The review presents data on the medications for the treatment of osteoporosis and approaches to the treatment of glucocorticoid osteoporosis.
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Nowakowska-Płaza, Anna, Jakub Wroński, Iwona Sudoł-Szopińska et Piotr Głuszko. « Clinical Utility of Trabecular Bone Score (TBS) in Fracture Risk Assessment of Patients with Rheumatic Diseases Treated with Glucocorticoids ». Hormone and Metabolic Research 53, no 08 (août 2021) : 499–503. http://dx.doi.org/10.1055/a-1528-7261.
Texte intégralRésumé :
AbstractChronic glucocorticoid therapy is associated with osteoporosis and can cause fractures in up to 50% of patients. Increased risk of fractures in patients with glucocorticoid-induced osteoporosis does not result only from the decreased bone mineral density (BMD) but also bone microarchitecture deterioration. Trabecular bone score (TBS) is a method complementary to DXA, providing additional information about trabecular bone structure. The aim of this study was to assess the clinical utility of TBS in fracture risk assessment of patients treated with glucocorticoids. Patients with rheumatic diseases treated with glucocorticoids for at least 3 months were enrolled. All recruited patients underwent DXA with additional TBS assessment. We analyzed the frequency of osteoporosis and osteoporotic fractures and assessed factors that might be associated with the risk of osteoporotic fractures. A total of 64 patients were enrolled. TBS and TBS T-score values were significantly lower in patients with osteoporosis compared to patients without osteoporosis. Low energy fractures occurred in 19 patients. The disturbed bone microarchitecture was found in 30% of patients with fractures without osteoporosis diagnosis based on BMD. In the multivariate analysis, only TBS and age were significantly associated with the occurrence of osteoporotic fractures. TBS reflects the influence of glucocorticoid therapy on bone quality better than DXA measured BMD and provides an added value to DXA in identifying the group of patients particularly prone to fractures.
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Kozyreva, M. V., O. A. Nikitinskaya et N. V. Toroptsova. « Trabecular bone score in rheumatic disease ». Rheumatology Science and Practice 60, no 6 (25 décembre 2022) : 587–93. http://dx.doi.org/10.47360/1995-4484-2022-587-59.
Texte intégralRésumé :
Patients with rheumatic diseases (RD) are at high risk of osteoporosis (OP) and osteoporotic fractures. The Trabecular bone score (TBS) is a relatively novel method of assessing bone quality, which independently predicts fracture risk regardless of bone mineral density (BMD). A lower TBS in patients with RD compared to controls is shown in most studies concerning TBS and RD. The data obtained indicate that TBS predicts fractures better in RD, especially in patients receiving glucocorticoids, than BMD or the FRAX algorithm. TBS degradation has been associated with disease activity in ankylosing spondylitis, systemic sclerosis, and rheumatoid arthritis in a few studies. However, there is little data in the literature on the effect of rheumatic disease therapy and OP treatment in patients with RD on predictive ability of TBS for incident fracture.
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Gladkov, E. N., E. V. Kozhemyakina, L. P. Evstigneeva, V. A. Tikhonova, L. N. Kamkina, O. V. Bannykh, V. M. Balueva et O. M. Lesnyak. « OSTEOPOROSIS AND ASSOCIATED FRACTURES IN OLDER PATIENTS WITH INFLAMMATORY RHEUMATIC DISEASES ». Osteoporosis and Bone Diseases 18, no 2 (15 décembre 2015) : 9–14. http://dx.doi.org/10.14341/osteo201529-14.
Texte intégralRésumé :
Aim. To estimate the burden of fractures in patients with rheumatic inflammatory diseases. Materials and Methods. A specially designed questionnaire was introduced to patients of rheumatic department of Sverdlovsk regional hospital № 1. The study included 242 patients aged 50 to 79 years (mean age 58.4± 6.5 years, 194 women and 48 men). Results. High incidence of osteoporosis (35.5%) was observed in patients with rheumatic inflammatory diseases. Intervention threshold (FRAX) was identified in 46.8% of patients. Low-energy fractures of the skeleton were identified in 33.9% of patient. Oral glucocorticoid therapy increased the risk (odds ratio (95% confidence interval (95% CI)) of osteoporotic fractures by 2.68-fold (95% CI 1.55 - 4.63, p=0.004). Conclusion. High incidence of osteoporosis and osteoporotic fractures was observed in patients with rheumatic inflammatory diseases.
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Rossini, M., O. Viapiana, M. Vitiello, N. Malavolta, G. La Montagna, S. Maddali Bongi, O. Di Munno et al. « Prevalence and incidence of osteoporotic fractures in patients on long-term glucocorticoid treatment for rheumatic diseases : the Glucocorticoid Induced OsTeoporosis TOol (GIOTTO) study ». Reumatismo 69, no 1 (22 mai 2017) : 30. http://dx.doi.org/10.4081/reumatismo.2017.922.
Texte intégralRésumé :
Osteoporosis and fractures are common and invalidating consequences of chronic glucorticoid (GC) treatment. Reliable information regarding the epidemiology of GC induced osteoporosis (GIOP) comes exclusively from the placebo group of randomized clinical trials while observational studies are generally lacking data on the real prevalence of vertebral fractures, GC dosage and primary diagnosis. The objective of this study was to evaluate the prevalence and incidence of osteoporotic fractures and to identify their major determinants (primary disease, GC dosage, bone mineral density, risk factors, specific treatment for GIOP) in a large cohort of consecutive patients aged >21 years, on chronic treatment with GC (≥5 mg prednisone - PN - equivalent) and attending rheumatology centers located all over Italy. Glucocorticoid Induced OsTeoporosis TOol (GIOTTO) is a national multicenter cross-sectional and longitudinal observational study. 553 patients suffering from Rheumatoid Arthritis (RA), Polymyalgia Rheumatica (PMR) and Connective Tissue Diseases (CTDs) and in chronic treatment with GCs were enrolled. Osteoporotic BMD values (T score <-2.5) were observed in 28%, 38% and 35% of patients with CTDs, PMR or RA at the lumbar spine, and in 18%, 29% and 26% at the femoral neck, respectively. Before GC treatment, prevalent clinical fractures were reported by 12%, 37% and 17% of patients with CTDs, PMR, or RA, respectively. New clinical fragility fractures during GC treatment were reported by 12%, 10% and 23% of CTDs, PMR and RA patients, respectively. Vertebral fractures were the prevailing type of fragility fracture. More than 30% of patients had recurrence of fracture. An average of 80% of patients were in supplementation with calcium and/or vitamin D during treatment with GCs. Respectively, 64%, 80%, and 72% of the CTDs, PMR and RA patients were on pharmacological treatment for GIOP, almost exclusively with bisphosphonates. The GIOTTO study might provide relevant contributions to clinical practice, in particular by highlighting and quantifying in real life the prevalence of GIOP and relative fractures, the frequency of the main risk factors, and the currently sub-optimal prevention. Moreover, these results emphasize the importance of the underlying rheumatic disease on the risk of GIOP associated fractures.
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Adami, G., A. Fassio, A. Giollo, G. Orsolini, O. Viapiana, D. Gatti et M. Rossini. « SAT0456 REAL-LIFE RISK OF FRACTURE AND TREATMENT PREVALENCE IN DRUG-INDUCED OSTEOPOROSIS IN ITALY USING A NEW ALGORITHM ». Annals of the Rheumatic Diseases 79, Suppl 1 (juin 2020) : 1185.1–1186. http://dx.doi.org/10.1136/annrheumdis-2020-eular.2565.
Texte intégralRésumé :
Background:Glucocorticoid-induced osteoporosis and osteoporosis induced by adjuvant hormone therapy for breast cancer are the most common forms of secondary osteoporosis.Objectives:The exact real-life prevalence of treatment with anti-osteoporotic drugs in women with drug-induced osteoporosis is not known. In the present study, using a new mathematical and computerized algorithm, we investigate the profile of risk of fracture of women with drug-induced osteoporosis and the prevalence of treatment with anti-osteoporotic drugs.Methods:We have retrospectively analyzed the 10-year risk of major osteoporotic fracture calculated with the DeFRAcalc79 tool in postmenopausal women aged over 50 years that were initiating an anti-osteoporotic treatment (fully reimbursed according to the Nota 79). DeFRAcalc79 is a new web-based fracture risk-assessment tool (https://defra-osteoporosi.it) that arithmetically adjusts the risk based on multiple risk factors contemplated by the Nota 79, which regulates the reimbursability for osteoporosis medications in Italy (Italian Agency for Drugs, AIFA), including demographic and anthropometric data, femoral and/or lumbar spine BMD T-score, family history of femoral or vertebral fractures, number and site of previous osteoporotic fracture (including vertebral, femoral, and non-vertebral non-femoral fractures), glucocorticoid treatment (> 3 or > 12 months, ≥5 mg prednisone or equivalent), adjuvant hormone therapy for breast cancer, and comorbidities that induce an increased risk of fracture (rheumatoid arthritis and other connective tissue diseases, chronic obstructive pulmonary disease, inflammatory bowel diseases, Parkinson’s disease, multiple sclerosis, human immunodeficiency virus infection, diabetes, or severe physical handicap). This is a sub-analysis of the cross-sectional observational study to validate and further develop the DeFRA algorithm for the estimation of the risk of osteoporotic fractures, promoted by Verona hospital with the unconditional support of Amgen Srl.Results:Among 208 women, 116 (55.8%) were treated with adjuvant hormone therapy for breast cancer and 92 (44.2%) were on glucocorticoid ≥5 mg/day. Women on glucocorticoids had a greater mean 10-year risk of fracture compared to women on adjuvant hormone therapy for breast cancer (67.0% vs 39.1% p<0.01). 50.7% of women on adjuvant hormone therapy for breast cancer used denosumab, 28.0% zoledronic acid and 17.3% alendronate. In glucocorticoid-induced osteoporosis, 17.6% of the women used teriparatide, 37.3% alendronate, 29.4% zoledronic acid and 13.7% denosumab.Conclusion:In our cohort of patients, treatment with adjuvant hormone therapy for breast cancer was slightly more common than glucocorticoids. Women with glucocorticoid-induced osteoporosis had a greater risk of fracture compared to patients treated with adjuvant hormone therapy for breast cancer. Half of the patients on adjuvant hormone therapy for breast cancer were prescribed with denosumab. One-fifth of the patients with glucocorticoid-induced osteoporosis was treated with teriparatide. DeFRAcalc79 is a useful and practical tool for the integrated evaluation of fracture risk in drug-induced osteoporosis.Disclosure of Interests:Giovanni Adami: None declared, Angelo Fassio Speakers bureau: Angelo Fassio reports personal fees from: Abiogen and Novartis, outside the submitted work., Alessandro Giollo: None declared, Giovanni Orsolini: None declared, Ombretta Viapiana: None declared, Davide Gatti Speakers bureau: Davide Gatti reports personal fees from Abiogen, Amgen, Janssen-Cilag, Mundipharma, outside the submitted work., Maurizio Rossini Speakers bureau: AbbVie, Abiogen, Amgen, BMS, Eli-Lilly, Novartis, Pfizer, Sanofi, Sandoz and UCB
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Adami, G., D. Gatti, A. Giollo, E. Bertoldo, O. Viapiana, P. Olivi, A. Fassio et M. Rossini. « OP0112 FACTORS ASSOCIATED WITH OSTEOPOROSIS CARE OF MEN : A REAL-LIFE STUDY ON A NATION-WIDE DATASET ». Annals of the Rheumatic Diseases 80, Suppl 1 (19 mai 2021) : 62.1–62. http://dx.doi.org/10.1136/annrheumdis-2021-eular.257.
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Background:Male osteoporosis is associated with an important clinical and economic burden worldwide. Notwithstanding that, undertreatment of men with osteoporosis is common. Understanding the factors associated with less osteoporosis care utilization might help define future intervention to improve access of men to osteoporosis care.Objectives:The aim of the study was to describe the factors associated with osteoporosis care in men.Methods:We conducted a retrospective analysis of a nation-wide cohort (DeFRACalc79 database). DeFRACalc79 is a tool that estimates the fracture risk considering clinical and densitometric risk factors, including the presence of prior hip or vertebral and non-vertebral or non-hip fractures. We compared the clinical characteristics of male individuals with an age matched cohort of women. Propensity score generation with 2:1 matching for female and male patients was performed matching the cohorts for age, generating propensity estimates with a logistic regression model.Results:We analyzed a sample of 4,902 men at high risk of osteoporosis. We found that the factors associated to osteoporosis care utilization in men were: the presence of comorbidities (OR 1.939, 95% CI 1.799-2.090), adjuvant hormonal therapy for prostate cancer (OR 1.482, 95% CI 1.315-1.670), the presence of vertebral or hip fractures (OR 1.490, 95% CI 1.378-1.611) and glucocorticoid treatment (OR 2.573, 95% CI 2.274-2.832) (Table 1)Table 1.Clinical and densitometric characteristics of the study population and age-matched cohort of womenMen (n=4,902)Women (n=9,804)OR (95% CI) – p valueAge (±SD)65.1 (±14.2)65.1 (±14.2)NSBMI (±SD)25.31 (±4.91)24.07 (±4.85)<0.0001Lumbar spine T-score (±SD)-2.13 (±1.37)-2.51 (±1.15)<0.0001Osteoporosis at lumbar spine (%)2,601 (53.1%)5,948 (60.7%)0.733 (0.684-0.785)Femoral neck T-score (±SD)-1.93 (±1.04)-2.19 (±0.91)<0.0001Osteoporosis at femoral neck (%)1,412 (28.8%)3,936 (40.1%)0.603 (0.560-0.649)% 10-year risk of fracture (±SD)22.77 (±21.05)20.26 (±4.85)<0.0001Family history of fragility fracture (%)891 (18.2%)2,379 (24.3%)0.693 (0.636-0.756)Secondary osteoporosis (%)2,415 (49.3%)3,092 (31.5%)2.108 (1.965-2.262)Glucocorticoids ≥5 mg/day >3 months (%)768 (17.4%)694 (7.7%)2.573 (2.274-2.832)Glucocorticoids ≥5 mg/day ≥3 months <12 months (%)74 (2.0%)72 (0.9%)2.357 (1.700-3.267)Glucocorticoids ≥5 mg/day ≥12 months (%)119 (3.2%)138 (1.6%)1.977 (1.543-2.534)Adjuvant hormonal therapy for breast cancer or prostate cancer (%)495 (12.0%)766 (8.4%)1.482 (1.315-1.670)Comorbidities (%)1,778 (36.3%)2,225 (22.7%)1.939 (1.799-2.090)Rheumatoid arthritis (%)303 (8.8%)511 (6.3%)1.439 (1.241-1.668)Psoriatic arthritis (%)59 (1.9%)103 (1.3)1.390 (1.006-1.919)Systemic lupus erythematosus (%)22 (0.7%)77 (1.0%)0.693 (0.431-1.115)Systemic sclerosis (%)9 (0.3%)60 (0.8%)0.364 (0.180-0.734)Other rheumatic diseases (%)173 (5.2%)310 (3.9%)1.354 (1.119-1.638)Inflammatory bowel diseases (%)144 (2.7%)126 (1.6%)2.773 (2.175-3.534)Chronic obstructive pulmonary disease (%)281 (8.3%)277 (3.5%)2.461 (2.074-2.920)Diabetes (%)441 (12.4%)478 (5.9%)2.238 (1.954-2.564)Neurological diseases (%)236 (7.0%)260 (3.3%)2.202 (1.837-2.639)HIV infection (%)110 (3.4%)23 (0.3%)11.603 (7.389-18.221)Vertebral or hip fractures (%)1,434 (29.3%)2,130 (21.7%)1.490 (1.378-1.611)Non-vertebral, non-hip fractures (%)534 (10.9%)1,477 (15.1%)0.689 (0.620-0.766)Conclusion:We found that men accessed osteoporosis care with more severe osteoporosis and/or with a diagnosis of secondary osteoporosis. Male osteoporosis remains largely underdiagnosed with a dramatic latency in osteoporosis care utilization compared to women.Disclosure of Interests:None declared
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Buehring, Bjoern, Friederike Thomasius, Katharina Schultz et Uwe Maus. « Osteoporosis and Rheumatoid Arthritis-Diagnosis, Diagnostics and Therapy ». Osteologie 30, no 04 (novembre 2021) : 326–34. http://dx.doi.org/10.1055/a-1648-4414.
Texte intégralRésumé :
AbstractMany inflammatory rheumatic diseases are associated with an increased fracture risk. Causes include the pro-inflammatory cytokines which are elevated in these diseases, reduced mobility and physical activity often caused by joint pain, and medications that negatively affect bone quality. Osteoporosis, the loss of bone mass and structure is the result. This review article summarizes the current diagnostic and therapeutic osteoporosis recommendations for patients with rheumatoid arthritis. It should be emphasized that early measures for the detection and treatment of osteoporosis are particularly important, since the risk factor constellation often present in this patient population leads to a relatively high imminent fracture risk at the beginning of the disease and the start of glucocorticoid therapy. Treatment initiations as early as possible with effective control of inflammatory activity is therefore essential to reduce the risk of osteoporosis. The administration of glucocorticoids should be reduced as far as the clinical context allows. Fracture risk should be assessed when the RA diagnosis is made and in regular intervals thereafter. Osteoporosis medication should be initiated based on the overall fracture risk. The choice of medication is based on the particular risk and indication. The basis of therapy is an adequate intake of vitamin D and calcium and adapted physical activity
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Dobrovolskaya, O. V., N. V. Dyomin, A. V. Smirnov, I. A. Shornikova et N. V. Toroptsova. « Bone mineral density in women of reproductive age with rheumatic diseases ». Medical alphabet 2, no 37 (20 janvier 2020) : 7–11. http://dx.doi.org/10.33667/2078-5631-2019-2-37(412)-7-11.
Texte intégralRésumé :
The article is devoted to the study of bone mineral density (BMD) in women of reproductive age suffering from rheumatic diseases (RD). A survey was conducted of 134 women — 94 patients with RD (rheumatoid arthritis, systemic scleroderma and psoriatic arthritis) and 40 people without RD. Reduced BMD was detected significantly more often in the group of patients with RE compared with the healthy control (25 and 8 %, respectively; p = 0.0213). Patients with RD showed a direct association of BMD values in all measurement areas with height, weight, body mass index, serum vitamin D concentration, and the reverse — with a cumulative dose of glucocorticoids; For MPC of the proximal femur, an additional relationship was revealed with the duration of RD. Thus, a quarter of women with RD in reproductive age need to be monitored, and in the presence of fractures, treatment of osteoporosis.
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Dobrovolskaya, O. V., A. O. Efremova, N. V. Demin et N. V. Toroptsova. « Bone mineral density and fracture risk in patients with rheumatic diseases ». Meditsinskiy sovet = Medical Council, no 8 (16 juillet 2020) : 120–27. http://dx.doi.org/10.21518/2079-701x-2020-8-120-127.
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Introduction: Decrease in bone mineral density (BMD) and risk of fractures in rheumatic diseases (RD) is caused by the pathogenetic mechanisms underlying RD and the effects of drugs used to treat them on bone.Aim of the study: to assess the condition of BMD, frequency and risk of fractures in postmenopausal women with different RD.Material and methods: The study enrolled 260 women in postmenopause (median age 61 years) (54; 68 year) with systemic scleroderma (SS), rheumatoid arthritis (RA) and osteoarthritis (OA). Patients were sanitized and examined using dual energy X-ray absorptiometry; a 10-year risk of fractures was calculated using the FRAX® algorithm.Results: A reduced BMD was observed in 210 (81%) women with RD, while osteoporosis (OP) was found in 43% of women with SS, 31% of women with RA and 17% of women with OA. In all RD, osteoporosis was more common in the lumbar spine than in the proximal femur. The frequency of low-energy fractures in the anamnesis was 35, 29 and 20 percent for those with SS, RA and OA, respectively. The most frequent fractures among women with SS and RA were vertebral fractures, and in patients with OA - forearm fractures. The 10-year risk of new fractures according to FRAX® and the need for antiosteoporotic treatment in women with OA was less than in patients with SS and RA (p < 0.0001). Of all patients examined, 44% needed pathogenetic antiosteoporotic therapy, and in actual practice 25% of women received it. Patients with RA were most often treated with zoledronic acid, alendronate and parenteral form of ibandronate.Conclusions: The frequency of OPs and the 10-year risk of fractures in autoimmune RD was significantly higher than in OA. The structure of low-energy fractures in RD is different: in autoimmune processes and glucocorticoids (GC) intake, spinal compression fractures were significantly more common. Pathogenetic treatment for OP in women in post-menopause with RD is not performed frequently enough, which may cause repeated low-energy fractures.
Thèses sur le sujet "Glucocorticoids, rheumatic diseases, osteoporosis, fractures"
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Maria, Vitiello. « PREVALENCE AND INCIDENCE OF OSTEOPOROTIC FRACTURES IN PATIENTS ON LONG-TERM GLUCOCORTICOID TREATMENT FOR RHEUMATIC DISEASES : The Glucocorticoid Induced OsTeoporosis TOol, GIOTTO STUDY ». Doctoral thesis, 2018. http://hdl.handle.net/11562/985893.
Texte intégralRésumé :
Background: Osteoporosis and fractures are common and invalidating consequences of chronic glucorticoid (GCs) treatment. Reliable information regarding the epidemiology of GCs induced osteoporosis (GIOP) are coming exclusively from the placebo group of randomized clinical trials while observational studies are generally lacking data on the real prevalence of vertebral fractures, GC dose and primary diagnosis. Objectives: The objective of this study was to evaluate the prevalence and incidence of osteoporotic fractures and to identify their major determinants (primary disease, GCs dose, bone mineral density,risk factors, specific treatment for GIOP) in a large cohort of consecutive patients aged > 21 years, on chronic treatment with GC (≥5 mg prednisone –PN- equivalent), attending rheumatology centers located all over Italy. Methods:This is a national multicenter cross-sectional and longitudinal observational study (The Glucocorticoid Induced OsTeoporosis TOol, GIOTTO Study). 553 patients suffering from Rheumatoid Arthritis (RA), Polymyalgia Rheumatica (PMR) and Connective Tissue Diseases (CTDs) and in chronic treatment with GCs were enrolled. Results: Osteoporotic BMD values (T score < -2.5) were observed in 28%, 38% and 35% of the patients with CTDs, PMR or RA at the lumbar spine, and in 18%, 29% and 26% at the femoral neck, respectively. Before GC treatment prevalent clinical fractures had been reported by 12%, 37% and 17% of patients with CTDs, PMR, and RA, respectively. New clinical fragility fractures during GC treatment was reported by 12%, 10% and 23% of CTDs, PMR and RA patients, respectively. Vertebral fractures were the prevailing type of fragility fracture. More than 30% of patients had recurrence of fracture. An average of 80% of patients were in supplementation with calcium and/or vitamin D during treatment with GCs. Respectively,64%, 80%, and 72% of the CTDs, PMR and RApatients were on pharmacological treatment for GIOP, almost exclusively with bisphosphonates. Conclusions: The GIOTTO study might provide relevant contributions in clinical practice, in particular by highlighting and quantifying in real life the prevalence of GIOP and relative fractures, the frequency of the main risk factors, and the currently sub-optimal prevention. Moreover, these results emphasize the importance of the underlying rheumatic disease on the risk of GIOP associated fractures.
Chapitres de livres sur le sujet "Glucocorticoids, rheumatic diseases, osteoporosis, fractures"
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Harvey, Nicholas, Sarah Westlake, Elaine Dennison et Cyrus Cooper. « The Epidemiology of Osteoporotic Fractures ». Dans Osteoporosis and the Osteoporosis of Rheumatic Diseases, 1–13. Elsevier, 2006. http://dx.doi.org/10.1016/b978-0-323-03437-1.50008-7.
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Mazziotti, Gherardo, Andrea Giustina, Ernesto Canalis et John P. Bilezikian. « Glucocorticoid-induced osteoporosis ». Dans Oxford Textbook of Endocrinology and Diabetes, 754–59. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199235292.003.0497.
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Synthetic glucocorticoids are used in a wide variety of disorders including autoimmune, pulmonary, and gastrointestinal diseases, as well as in patients following organ transplantation and with malignancies. Although the indications for glucocorticoids in these various conditions are clear, their use is fraught with a host of potential side effects. In particular, glucocorticoids are detrimental to bone and glucocorticoid-induced osteoporosis (GIO) is the most common form of secondary osteoporosis (1). Despite the fact that glucocorticoids can cause bone loss and fractures, many patients receiving or initiating long-term glucocorticoid therapy are not evaluated for their skeletal health. Furthermore, patients often do not receive specific preventive or therapeutic agents when indicated. New knowledge of the pathophysiological mechanisms underlying GIO has been accompanied by the availability of effective strategies to prevent and treat GIO (1).
Actes de conférences sur le sujet "Glucocorticoids, rheumatic diseases, osteoporosis, fractures"
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Fernández-Melón, J., M. Bernad, ML Gonzalez, C. Gonzalez, MV Garces, E. Martin-Mola et ME Martinez. « OP0115 Polymorphism at the type i collagen (colia1) and relative risk of osteoporosis and vertebral fractures in postmenopausal women ». Dans Annual European Congress of Rheumatology, Annals of the rheumatic diseases ARD July 2001. BMJ Publishing Group Ltd and European League Against Rheumatism, 2001. http://dx.doi.org/10.1136/annrheumdis-2001.481.
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Paiva, L., S. Filardi, AM Pinto-Neto, A. Samara et JF Marques-Neto. « AB0171 Impact of degenerative radiological abnormalities and vertebral fractures on the evaluation of spinal bone density in women with osteoporosis ». Dans Annual European Congress of Rheumatology, Annals of the rheumatic diseases ARD July 2001. BMJ Publishing Group Ltd and European League Against Rheumatism, 2001. http://dx.doi.org/10.1136/annrheumdis-2001.610.
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Wasnich, RD, MC Hochberg, S. Greenspan, PD Ross et PD Miller. « OP0113 Increases in bone mineral density explain the reduction in incidence of nonvertebral fractures seen with antiresorptive therapy in women with postmenopausal osteoporosis ». Dans Annual European Congress of Rheumatology, Annals of the rheumatic diseases ARD July 2001. BMJ Publishing Group Ltd and European League Against Rheumatism, 2001. http://dx.doi.org/10.1136/annrheumdis-2001.634.
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