Management of glucocorticoid-induced osteoporosis
Tóm tắt
Long-term glucocorticoid (GC) therapy is frequently indicated to treat autoimmune and chronic inflammatory diseases in daily clinical practice. Two of the most devastating untoward effects are bone loss and fractures. Doses as low as 2.5 mg of prednisone for more than 3 months can impair bone integrity. Population at risk is defined based on the dose and duration of GC therapy and should be stratified according to FRAX (Fracture Risk Assessment Tool), major osteoporotic fracture, prior fractures, and bone mineral density values (BMD). General measures include to prescribe the lowest dose of GC to control the underlying disease for the shortest possible time, maintain adequate vitamin D levels and calcium intake, maintain mobility, and prescribe a bone acting agent in patients at high risk of fracture. These agents include oral and intravenous bisphosphonates, denosumab, and teriparatide.
Tài liệu tham khảo
Kanis JA, Johansson H, Oden A et al (2004) A meta-analysis of prior corticosteroid use and fracture risk. J Bone Miner Res 19:893–899
Díez-Pérez A, Hooven FH, Adachi JD et al (2011) Regional differences in treatment for osteoporosis. The Global Longitudinal Study of Osteoporosis in Women (GLOW). Bone 49:493–498
Van Staa TP, Leufkens HG, Cooper C (2002) The epidemiology of corticosteroid-induced osteoporosis: a meta-analysis. Osteoporos Int 13:777–787
Natsui K, Tanaka K, Suda M et al (2006) High-dose glucocorticoid treatment induces rapid loss of trabecular bone mineral density and lean body mass. Osteoporos Int 17:105–108
Adachi JD, Saag KG, Delmas PD et al (2001) Two-year effects of alendronate on bone mineral density and vertebral fracture in patients receiving glucocorticoids: a randomized, double-blind, placebo-controlled extension trial. Arthritis Rheum 44:202–211
Cohen S, Levy RM, Keller M et al (1999) Risedronate therapy prevents corticosteroid-induced bone loss: a twelve month, multicenter, randomized, double-blind, placebo-controlled, parallel-group study. Arthritis Rheum 42:2309–2318
Reid DM, Devogelaer JP, Saag K et al (2009) Zoledronic acid and risedronate in the prevention and treatment of glucocorticoid-induced osteoporosis (HORIZON): a multicentre, double-blind, double-dummy, randomised controlled trial. Lancet 373:1253–1263
van Staa TP, Leufkens HG, Abenhaim L et al (2000) Use of oral corticosteroids and risk of fractures. J Bone Miner Res 15:993–1000
van Staa TP, Geusens P, Pols HA et al (2005) A simple score for estimating the long-term risk of fracture in patients using oral glucocorticoids. QJM 98:191–198
Waljee AK, Rogers MA, Lin P et al (2017) Short term use of oral corticosteroids and related harms among adults in the United States: population-based cohort study. BMJ 357:j1415
Amiche MA, Abtahi S, Driessen JHM et al (2018) Impact of cumulative exposure to high-dose oral glucocorticoids on fracture risk in Denmark: a population-based case-control study. Arch Osteoporos 13:30
De Vries F, Bracke M, Leufkens HG et al (2007) Fracture risk with intermittent high-dose oral glucocorticoid therapy. Arthritis Rheum 56:208–214
Schett G, Saag KG, Bijlsma JW (2010) From bone biology to clinical outcome: state of the art and future perspectives. Ann Rheum Dis 69:1415–1419
Best JH, Kong AM, Lenhart GM et al (2018) Association between glucocorticoid exposure and health care expenditures for potential glucocorticoid-related adverse events in patients with rheumatoid arthritis. J Rheumatol 45:320–328
Buttgereit F, Straub RH, Wehling M et al (2004) Glucocorticoids in the treatment of rheumatic diseases: an update on the mechanisms of action. Arthritis Rheum 50:3408–3417
O’Brien CA, Jia D, Plotkin LI et al (2004) Glucocorticoids act directly on osteoblasts and osteocytes to induce their apoptosis and reduce bone formation and strength. Endocrinology 145:835–841
Hildebrandt S, Baschant U, Thiele S et al (2018) Glucocorticoids suppress Wnt16 expression in osteoblasts in vitro and in vivo. Sci Rep 8:8711
Ohlsson C, Nilsson KH, Henning P et al (2018) WNT16 overexpression partly protects against glucocorticoid-induced bone loss. Am J Physiol Endocrinol Metab 314:E597–E604
Ohnaka K, Tanabe M, Kawate H et al (2005) Glucocorticoid suppresses the canonical Wnt signal in cultured human osteoblasts. Biochem Biophys Res Commun 329:177–181
Wang FS, Ko JY, Yeh DW et al (2008) Modulation of Dickkopf-1 attenuates glucocorticoid induction of osteoblast apoptosis, adipocytic differentiation, and bone mass loss. Endocrinology 149:1793–1801
Kato T, Khanh VC, Sato K et al (2018) Elevated expression of Dkk-1 by glucocorticoid treatment impairs bone regenerative capacity of adipose tissue-derived mesenchymal stem cells. Stem Cells Dev 27:85–99
Butler JS, Queally JM, Devitt BM et al (2010) Silencing Dkk1 expression rescues dexamethasone-induced suppression of primary human osteoblast differentiation. BMC Musculoskelet Disord 11:210
Cárcamo-Orive I, Gaztelumendi A, Delgado J et al (2010) Regulation of human bone marrow stromal cell proliferation and differentiation capacity by glucocorticoid receptor and AP-1 crosstalk. J Bone Miner Res 25:2115–2125
Hofbauer LC, Gon F, Riggs BL et al (1999) Stimulation of osteoprotegerin ligand and inhibition of osteoprotegerin production by glucocorticoids in human osteoblastic lineage cells: potential paracrine mechanisms of glucocorticoid-induced osteoporosis. Endocrinology 140:4382–4389
Pereira RMR, Delany AM, Durant D et al (2002) Cortisol regulates the expression of notch in osteoblasts. J Cell Biochem 85:252–258
Zanotti S, Yu J, Adhikari S et al (2018) Glucocorticoids inhibit notch target gene expression in osteoblasts. J Cell Biochem 119:6016–6023
Zhang S, Liu Y, Liang Q (2018) Low-dose dexamethasone affects osteoblast viability by inducing autophagy via intracellular ROS. Mol Med Rep 17:4307–4316
Weinstein RS, Hogan EA, Borelli MJ et al (2017) The pathophysiological sequence of glucocorticoid-induced osteonecrosis of the femoral head in male mice. Endocrinology 158:3817–3831
Schakman O, Kalista S, Barbe C et al (2013) Glucocorticoid-induced skeletal muscle atrophy. Int J Biochem Cell Biol 45:2163–2172
Sculz P, Beck TJ, Marchand F et al (2005) Low skeletal muscle mass is associated with poor structural parameters of bone and impaired balance in elderly men—the MINOS study. J Bone Miner Res 20:721–729
Weinstein RS (2011) Clinical practice. Glucocorticoid-induced bone disease. N Engl J Med 365:62–70
Canalis E, Mazziotti G, Giustina A et al (2007) Glucocorticoid-induced osteoporosis: pathophysiology and therapy. Osteoporos Int 18:1319–1328
Hu K, Adachi JD (2019) Glucocorticoid induced osteoporosis. Expert Rev Endocrinol Metabol 14:259–266
Lane NE (2019) Glucocorticoid-induced osteoporosis: new insights into the pathophysiology and treatments. Curr Osteoporos Rep 17:1–7
Compston J (2018) Glucocorticoid-induced osteoporosis: an update. Endocrine 61:7–16
Adami G, Saag KG (2019) Glucocorticoid-induced osteoporosis: 2019 concise clinical review. Osteoporos Int 30:1145–1156
Lekamwasam S, Adachi JD, Agnusdei D et al (2012) A framework for the development of guidelines for the management of glucocorticoid-induced osteoporosis. Osteoporos Int 23:2257–2276
Buckley L, Guyatt G, Fink HA et al (2017) 2017 American College of Rheumatology guideline for the prevention and treatment of glucocorticoid-induced osteoporosis. Arthritis Rheumatol 69:1521–1537
Shuhart CR, Yeap SS, Anderson PA et al (2019) Executive summary of the 2019 ISCD position development conference on monitoring treatment, DXA cross-calibration and least significant change, spinal cord injury, peri-prosthetic and orthopedic bone health, transgender medicine, and pediatrics. J Clin Densitom 22:453–471
Iacopo C, Alberto F, Daniela M et al (2020) Updates in epidemiology, pathophysiology and management strategies of glucocorticoid-induced osteoporosis. Expert Rev Endocrinol Metabol 15:283–298
Silva BC, Leslie WD, Resch H et al (2014) Trabecular bone score: a noninvasive analytical method based upon the DXA image. J Bone Miner Res 29:518–530
Dubrovsky AM, Maricic M, Lane NE (2020) Glucocorticoid-induced osteoporosis. In: Leaer BZ, Wein MN (eds) Osteoporosis: pathophysiology and clinical management, 3rd edn. Humana, Cham, pp 407–418
Leib ES, Winzenrieth R (2016) Bone status in glucocorticoid-treated men and women. Osteoporos Int 27:39–48
Florez H, Hernández-Rodríguez J, Muxi A et al (2020) Trabecular bone score improves fracture risk assessment in glucocorticoid-induced osteoporosis. Rheumatology 59:1574–1580
Saag KG, Agnusdei D, Hans D et al (2016) Trabecular bone score in patients with chronic glucocorticoid therapy-induced osteoporosis treated with alendronate or teriparatide. Arthritis Rheumatol 68:2122–2128
Leib ES, Saag KG, Adachi JD et al (2011) Official positions for FRAX® clinical regarding glucocorticoids: the impact of the use of glucocorticoids on the estimate by FRAX® of the 10-year risk of fracture: from Joint Official Positions Development Conference of the International Society for Clinical Densitometry and International Osteoporosis Foundation on FRAX®. J Clin Densitom 14:212–219
Güler-Yüksel M, Hoes JN, Bultink IE et al (2018) Glucocorticoids, inflammation and bone. Calcif Tissue Int 102:592–606
Kanis JA, Johansson H, Oden A et al (2011) Guidance for the adjustment of FRAX according to the dose of glucocorticoids. Osteoporos Int 22:809–816
Buckley L, Humphrey MB (2018) Glucocorticoid-induced osteoporosis. New Engl J Med 379:2547–2556
Compston J, Cooper A, Cooper C et al (2017) UK clinical guideline for the prevention and treatment of osteoporosis. Arch Osteoporos 12:43
Briot K, Cortet B, Roux C et al (2014) 2014 update of recommendations on the prevention and treatment of glucocorticoid-induced osteoporosis. J Bone Spine 81:493–501
Rizzoli R, Biver E (2015) Glucocorticoid-induced osteoporosis: who to treat with what agent? Nat Rev Rheumatol 11:98
Drake MT, Clarke BL, Khosla S (2008) Bisphosphonates: mechanism of action and role in clinical practice. Mayo Clin Proc 83:1032–1045
Allen CS, Yeung JH, Vandermeer B et al (2016) Bisphosphonates for steroid-induced osteoporosis. Cochrane Database Syst Rev 10:CD001347
Amiche MA, Levesque LE, Gomes T et al (2018) Effectiveness of oral bisphosphonates in reducing fracture risk among oral glucocorticoid users: three matched cohort analyses. J Bone Miner Res 33:419–429
Axelsson KF, Nilsson AG, Wedel H et al (2017) Association between alendronate use and hip fracture risk in older patients using oral prednisolone. JAMA 318:146–155
Bergman J, Nordstrom A, Nordstrom P (2018) Alendronate use and the risk of nonvertebral fracture during glucocorticoid therapy: a retrospective cohort study. J Clin Endocrinol Metab 103:306–313
Saag KG, Wagman RB, Geusens P et al (2018) Denosumab versus risedronate in glucocorticoid-induced osteoporosis: a multicentre, randomised, double-blind, active-controlled, double-dummy, non-inferiority study. Lancet Diabetes Endocrinol 6:445–454
Saag KG, Pannacciulli N, Geusens P et al (2019) Denosumab vs risedronate in glucocorticoid-induced osteoporosis: final results of a 24-month randomized, double-blind, double-dummy trial. Arthritis Rheumatol 71:1174–1184
Saag KG, Shane E, Boonen S et al (2007) Teriparatide or alendronate in glucocorticoid-induced osteoporosis. N Engl J Med 357:2028–2039
Saag KG, Zanchetta JR, Devogelaer JP et al (2009) Effects of teriparatide versus alendronate for treating glucocorticoid-induced osteoporosis: thirty-six-month results of a randomized, double-blind, controlled trial. Arthritis Rheum 60:3346–3355
Karras D, Stoykov I, Lems WF et al (2012) Effectiveness of teriparatide in postmenopausal women with osteoporosis and glucocorticoid use: 3-year results from the EFOS study. J Rheumatol 39:600–609
Silverman S, Curtis J, Saag K et al (2015) International management of bone health in glucocorticoid-exposed individuals in the observational GLOW study. Osteoporos Int 26:419–420
Van der Goes MC, Jacobs JWG, Boers M et al (2010) Patient and rheumatologist perspectives on glucocorticoids: EULAR recommendations on the management of glucocorticoid therapy in rheumatic diseases. Ann Rheum Dis 69:1015–1021
Briot K, Geusens P, Bultink IEM et al (2017) Inflammatory Diseases and bone fragility. Osteoporos Int 28:3301–3314
Raterman H, Bultink IEM, Lems WF (2019) Current treatments and new developments in the management of glucocorticoid-induced osteoporosis. Drugs 79:1065–1087
Weaver CM, Gordon CM, Janz KF et al (2016) The National Osteoporosis Foundation’s position statement on peak bone mass development and lifestyle factors: a systematic review and implementation recommendations. Osteoporos Int 27:1281–1386
Briot K, Roux C (2015) Glucocorticoid-induced osteoporosis. RMD Open 1:e000014
Lips P (2007) Relative value of 25(OH)D and 1,25(OH)2D measurements. J Bone Miner Res 22:1668–1671
Gillespie LD, Robertson MC, Gillespie WJ et al (2012) Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD007146.pub3
Kanis JA, Johnell O, Oden A et al (2005) Smoking and fracture risk: a meta-analysis. Osteoporos Int 16:155–162
Maurel DB, Boisseau N, Benhamou CL et al (2012) Alcohol and bone: review of dose effects and mechanisms. Osteoporos Int 23:1–16
Hoes JN, Jacobs JW, Boers M et al (2007) EULAR evidence-based recommendations on the management of systemic glucocorticoid therapy in rheumatic diseases. Ann Rheum Dis 66:1560–1567
Black DM, Abrahamsen B, Bouxsein ML et al (2018) Atypical femur fractures—review of epidemiology, relationship to bisphosphonates, prevention and clinical management. Endocr Rev 40:333–368
Raterman HG, de Nijs R, Lems WF (2020) Standpunt van de Nederlandse Vereniging voor Reumatologie inzake Glucocorticoïd-geïnduceerde Osteoporose. GIOP guideline Dutch Society Rheumatology. https://www.nvrnl/wp-content/uploads/2020/01/NVR-Concept-standpunt-GIOPpdf.2020
Saag KG, Petersen J, Brandi ML et al (2017) Romosozumab or alendronate for fracture prevention in women with osteoporosis. N Engl J Med 377:1417–1427
Cosman F, Crittenden DB, Adachi JD et al (2016) Romosozumab treatment in postmenopausal women with osteoporosis. N Engl J Med 375:1532–1543
Bliuc D, Alarkawi D, Nguyen TV et al (2015) Risk of subsequent fractures and mortality in elderly women and men with fragility fractures with and without osteoporotic bone density: the Dubbo Osteoporosis Epidemiology Study. J Bone Miner Res 30:637–646
Gluer CC, Marin F, Ringe JD et al (2013) Comparative effects of teriparatide and risedronate in glucocorticoid-induced osteoporosis in men: 18-month results of the EuroGIOPs trial. J Bone Miner Res 28:1355–1368
Pepe J, Body JJ, Hadji P et al (2020) Osteoporosis in premenopausal women: a clinical narrative review by the ECTS and the IOF. J Clin Endocrinol Metab 105:2487–2506
Van de Glind EMM, Willems HC, Eslami S et al (2016) Estimating the time to benefit for preventive drugs with the statistical process control method: an example with alendronate. Drugs Aging 33:347–353
Lems WF, Dreinhofer KE, Bischoff-Ferrari H et al (2017) EULAR/EFORT recommendations for management of patients older than 50 years with a fragility fracture and prevention of subsequent fractures. Ann Rheum Dis 76:802–810
Genant HK, Wu CY, van Kuijk C et al (1993) Vertebral fracture assessment using a semiquantitative technique. J Bone Miner Res 8:1137–1148
Kanis JA, Hans D, Cooper C et al (2011) Interpretation and use of FRAX in clinical practice. Osteoporos Int 22:2395–2411