Editorial
Bisphosphonates and glucocorticoid-induced osteoporosis: implications for patients with respiratory diseases
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Osteoporosis is a well known consequence of glucocorticoid treatment that can result in significant morbidity and mortality.1-4 Glucocorticoid-induced bone loss occurs early, usually within 6-12 months of starting therapy. During this time the rate of bone loss is rapid before decreasing or reaching a plateau.1 2 4 Clinically this decrease in bone mineral density puts patients at an increased risk of fracture.1 2 4 5 Specifically, with a decline in bone mass of one standard deviation below the mean for young adults, the risk of fracture doubles.5 Characteristically, glucocorticoid-induced osteopenia and osteoporosis occur at a faster rate in trabecular bone; consequently, the ribs and vertebrae are common sites of fracture, although hip fractures have also been reported.6 7 As long term treatment with oral glucocorticoids is a common practice in the management of patients with chronic respiratory diseases, strategies to decrease the burden of glucocorticoid-induced osteoporosis are needed.
Glucocorticoid-induced bone loss results from a decrease in
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