Korean Guideline for the Prevention and Treatment of Glucocorticoid-induced Osteoporosis.
10.4078/jrd.2018.25.4.263
- Author:
So Young PARK
1
;
Hyun Sik GONG
;
Kyoung Min KIM
;
Dam KIM
;
Hayoung KIM
;
Chan Hong JEON
;
Ji Hyeon JU
;
Shin Seok LEE
;
Dong Ah PARK
;
Yoon Kyoung SUNG
;
Sang Wan KIM
Author Information
1. Division of Endocrinology and Metabolism, Department of Internal Medicine, Kyung Hee University Hospital, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Denosumab;
Diphosphonates;
Glucocorticoids;
Osteporosis;
Teriparatide
- MeSH:
Adolescent;
Adult;
Bone Density;
Calcium;
Child;
Denosumab;
Diphosphonates;
Evidence-Based Practice;
Glucocorticoids;
Humans;
Korea;
Miners;
Osteoporosis*;
Osteoporotic Fractures;
Prednisolone;
Rheumatology;
Risk Assessment;
Teriparatide;
Treatment Failure;
Vitamin D
- From:Journal of Rheumatic Diseases
2018;25(4):263-295
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To develop guidelines and recommendations to prevent and treat glucocorticoid-induced osteoporosis (GIOP) in Korea. METHODS: The Korean Society for Bone and Mineral Research and the Korean College of Rheumatology developed this guideline based on Guidance for the Development of Clinical Practice Guidelines version 1.0 established by the National Evidence-Based Healthcare Collaborating Agency. This guideline was developed by adapting previously-published guidelines, and a systematic review and quality assessment were conducted. RESULTS: This guideline applies to adults aged 19 years or older who are using or plan to use glucocorticoids (GCs), but does not include children and adolescents. An initial assessment of fracture risk should be performed within 6 months of initial GC use. Fracture risk should be estimated using FRAX (Fracture Risk Assessment Tool) with adjustments for GC dose, previous osteoporotic fracture history, and bone mineral density (BMD) results. All patients taking more than 2.5 mg/day prednisolone or equivalent for more than 3 months are recommended to take adequate calcium and vitamin D. Patients at moderate to high fracture risk should be treated with additional osteoporosis medication. All patients continuing GC therapy should receive an annual BMD measurement, vertebral X-ray, and fracture risk assessment using FRAX. When a treatment failure is suspected, switching to another drug should be considered. CONCLUSION: This guideline is intended to provide guidance for clinicians in prevention and treatment of GIOP.
