Korean Guideline for the Prevention and Treatment of Glucocorticoid-induced Osteoporosis.
10.11005/jbm.2018.25.4.195
- Author:
So Young PARK
1
;
Hyun Sik GONG
;
Kyoung Min KIM
;
Dam KIM
;
Ha Young 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:Review
- Keywords:
Bisphosphonate;
Denosumab;
Glucocorticoids;
Osteporosis;
Teriparatide
- MeSH:
Adolescent;
Adult;
Bone Density;
Calcium;
Child;
Denosumab;
Evidence-Based Practice;
Glucocorticoids;
Humans;
Korea;
Miners;
Osteoporosis*;
Osteoporotic Fractures;
Prednisolone;
Rheumatology;
Risk Assessment;
Teriparatide;
Treatment Failure;
Vitamin D
- From:Journal of Bone Metabolism
2018;25(4):195-211
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: To develop guidelines and recommendations to prevent and treat glucocorticoid (GC)-induced osteoporosis (GIOP) in Korea. METHODS: The Korean Society for Bone and Mineral Research and the Korean College of Rheumatology have developed this guideline based on Guidance for the Development of Clinical Practice Guidelines ver. 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 performed. RESULTS: This guideline applies to adults aged ≥19 years who are using or plan to use GCs. It 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 the fracture-risk assessment tool (FRAX) after adjustments for GC dose, history of osteoporotic fractures, and bone mineral density (BMD) results. All patients administered with prednisolone or an equivalent medication at a dose ≥2.5 mg/day for ≥3 months are recommended to use adequate calcium and vitamin D during treatment. Patients showing a moderate-to-high fracture risk should be treated with additional medication for osteoporosis. All patients continuing GC therapy should undergo annual BMD testing, vertebral X-ray, and fracture risk assessment using FRAX. When treatment failure is suspected, switching to another drug should be considered. CONCLUSIONS: This guideline is intended to guide clinicians in the prevention and treatment of GIOP.
