[Prevention and treatment of glucocorticoid-induced osteoporosis in International and Italian scenarios].
نویسندگان
چکیده
Osteoporosis (OP) and increased risk of fracture (Fx) associated with chronic glucocorticoid treatment pushed panels of experts and scientific societies to produce recommendations for both prevention and treatment of glucocorticoid-induced OP (GIO). Recently the American College of Rheumatology developed and/or endorsed their updated guidelines and recommendations for the prevention and treatment of GIO. In these recommendations the use of FRAX tool, for the 10-year probability of a major osteoporotic Fx, was integrated with other clinical risk factors to define low-, medium-, and high-risk patients. Updated approaches are delineated for post-menopausal women and men >50 years, pre-menopausal women not of childbearing potential, men <50 years and pre-menopausal women of childbearing potential with a history of a fragility Fx. Alendronate, risedronate, and zoledronic acid are the first-line choice in the majority of patients, with teriparatide as a second-line option. Concerning Italian scenarios, alendronate and risedronate are therapeutic agents currently dispensed and fully paid by the Public Health Service for the prevention and treatment of GIO in all patients >50 years, receiving >5 mg/day prednisone equivalent for >3 months; more recently teriparatide has also been included, only for those patients presenting ≥1 prevalent fragility Fx and receiving >5 mg/day prednisone equivalent for >12 months. Also zoledronic acid has been approved by Italian Agency of the Drug (AIFA, 30/08/10) for "... post-menopausal women and men chronically treated with GC ad high risk of Fx", but the drug is dispensed exclusively at the hospital.
منابع مشابه
Expression of HCA2 Receptors in Femoral Epiphysis and Metaphysis of Rats with Dexamethasone-Induced Osteoporosis
The present study describes the changes in expression of hydroxy- carboxylic acid receptor 2 (HCA2 receptor) in femoral epiphysis and metaphysis of rats with glucocorticoid-induced osteoporosis (GIO). 16 growing male Sprauge dawley rats were randomly divided into two equal groups consisting of normal control and rats that were rendered osteoporotic by receiving 0.1 mg/kg/day dexamethasone throu...
متن کاملGlucocorticoid induced osteoporosis.
Glucocorticoid therapy is the most common cause of secondary osteoporosis and the leading iatrogenic cause of the disease. Often, the presenting manifestation is fracture, which occurs in 30% to 50% of patients receiving long-term glucocorticoid therapy. Glucocorticoid-induced osteoporosis predominantly affects regions of the skeleton that have abundant cancellous bone such as lumbar spine and ...
متن کاملGlucocorticoid-induced osteoporosis.
Glucocorticoid-induced osteoporosis is one of the most important side-effects of glucocorticoid use, leading to an increased fracture risk. In this review, recent advances in the understanding of the mechanisms of glucocorticoid-induced osteoporosis are summarised. Methods to identify persons at risk for fractures are discussed, as well as the new ACR recommendations for the prevention and trea...
متن کاملP-181: Protective Role of Vitamin E As An Alternative Treatment for Ovariectomized Osteoporotic Rats
Background: Osteoporosis one of the postmenopausal symptoms is characterized by bone loss. There is a link between excessive reactive oxygen species (ROS) formation, estrogen deficiency due to cessation of ovarian function and bone loss. Free radicals are responsible for causing osteoblast apoptosis and reducing osteoblastogenesis in bone remodeling. Vitamin E is a potent antioxidant with the a...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Reumatismo
دوره 63 2 شماره
صفحات -
تاریخ انتشار 2011