II. Risk Factors: Osteoporosis on long-term Corticosteroids

  1. Prednisone 1-5 mg: Relative Risk 1.9x
  2. Prednisone 5-10 mg: Relative Risk 4.5x
  3. Prednisone >10 mg: Relative Risk 32x

III. Evaluation: Obtain Bone Mineral Density

  1. Check BMD at baseline prior to therapy
  2. Check BMD every 6-12 months during first 2 years

IV. Prevention: Osteoporosis from long-term steroids

  1. Use lowest dose of a short-acting glucocorticoid
  2. Maintain a well-balanced, low Sodium diet (2-3 gram)
  3. Weight bearing Exercise and Isometric Exercise
  4. Calcium Supplementation 1500 mg/day
  5. Vitamin D Supplementation 400-800 IU/day
  6. Control Hypercalciuria with Thiazide Diuretics
  7. Treat Hypogonadism
    1. Menopause: Hormone Replacement Therapy
    2. Men with low testosterone: Testosterone Replacement
  8. Treat bone loss if it occurs with Corticosteroid use
    1. Hormone Replacement Therapy
    2. Bisphosphonates
    3. Calcitonin

Images: Related links to external sites (from Bing)

Related Studies (from Trip Database) Open in New Window