Challenges in the diagnosis and management of glucocorticoid-induced osteoporosis in younger and older adults

Madhuni Herath; Bente Langdahl; Peter R. Ebeling; Frances Milat

doi:10.1111/cen.14637

Challenges in the diagnosis and management of glucocorticoid-induced osteoporosis in younger and older adults

Madhuni Herath, Bente Langdahl, Peter R. Ebeling, Frances Milat

Medicine Monash Health

Research output: Contribution to journal › Review Article › Research › peer-review

14 Citations (Scopus)

Abstract

Objective: Glucocorticoids constitute a considerable risk for developing osteoporosis in both younger and older adults. However, currently available bone imaging modalities and fracture-risk assessment tools do not adequately capture the dramatic changes in bone microarchitecture, heterogeneity of glucocorticoid exposure, the impact of chronic disease and other osteoporosis risk factors on the assessment of osteoporosis in these individuals. Design: A narrative review is presented, following a systematic search of the literature from 2000 to 2021. Results: Our current appreciation of glucocorticoid-induced osteoporosis (GIO) is focused on older populations, with limited evidence to guide the investigation, risk assessment and treatment in premenopausal women and men less than 50 years. The impact of the underlying chronic disease on secondary osteoporosis in these younger adults is also poorly understood. Conclusion: Through this narrative review, we provide a comprehensive overview of and recommendations for optimising the management of this common cause of secondary osteoporosis younger and older adults.

Original language	English
Pages (from-to)	460-474
Number of pages	15
Journal	Clinical Endocrinology
Volume	96
Issue number	4
DOIs	https://doi.org/10.1111/cen.14637
Publication status	Published - Apr 2022

Keywords

bone
fracture
glucocorticoids
osteoporosis
premenopause
risk assessment
young adult

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1111/cen.14637

Cite this

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title = "Challenges in the diagnosis and management of glucocorticoid-induced osteoporosis in younger and older adults",

abstract = "Objective: Glucocorticoids constitute a considerable risk for developing osteoporosis in both younger and older adults. However, currently available bone imaging modalities and fracture-risk assessment tools do not adequately capture the dramatic changes in bone microarchitecture, heterogeneity of glucocorticoid exposure, the impact of chronic disease and other osteoporosis risk factors on the assessment of osteoporosis in these individuals. Design: A narrative review is presented, following a systematic search of the literature from 2000 to 2021. Results: Our current appreciation of glucocorticoid-induced osteoporosis (GIO) is focused on older populations, with limited evidence to guide the investigation, risk assessment and treatment in premenopausal women and men less than 50 years. The impact of the underlying chronic disease on secondary osteoporosis in these younger adults is also poorly understood. Conclusion: Through this narrative review, we provide a comprehensive overview of and recommendations for optimising the management of this common cause of secondary osteoporosis younger and older adults.",

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author = "Madhuni Herath and Bente Langdahl and Ebeling, {Peter R.} and Frances Milat",

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doi = "10.1111/cen.14637",

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AU - Herath, Madhuni

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AU - Ebeling, Peter R.

AU - Milat, Frances

N1 - Funding Information: Madhuni Herath is supported by the National Health and Medical Research Council (NHMRC, Australia) Postgraduate Scholarship and Peter R. Ebeling by an NHMRC Level 3 Investigator Grant. Funding Information: Madhuni Herath has no conflict of interests or disclosures to declare. Bente Langdahl has received research funding from Amgen and Novo Nordisk and Honoria for advisory boards and lectures from Amgen, UCB, Eli Lilly, Gedeon‐Richter and Gilead. Peter R. Ebeling has received research funding from Amgen, Eli‐Lilly and Alexion and honoraria from Amgen. Frances Milat has no conflict of interests or disclosures to declare. Publisher Copyright: © 2021 John Wiley & Sons Ltd.

PY - 2022/4

Y1 - 2022/4

N2 - Objective: Glucocorticoids constitute a considerable risk for developing osteoporosis in both younger and older adults. However, currently available bone imaging modalities and fracture-risk assessment tools do not adequately capture the dramatic changes in bone microarchitecture, heterogeneity of glucocorticoid exposure, the impact of chronic disease and other osteoporosis risk factors on the assessment of osteoporosis in these individuals. Design: A narrative review is presented, following a systematic search of the literature from 2000 to 2021. Results: Our current appreciation of glucocorticoid-induced osteoporosis (GIO) is focused on older populations, with limited evidence to guide the investigation, risk assessment and treatment in premenopausal women and men less than 50 years. The impact of the underlying chronic disease on secondary osteoporosis in these younger adults is also poorly understood. Conclusion: Through this narrative review, we provide a comprehensive overview of and recommendations for optimising the management of this common cause of secondary osteoporosis younger and older adults.

AB - Objective: Glucocorticoids constitute a considerable risk for developing osteoporosis in both younger and older adults. However, currently available bone imaging modalities and fracture-risk assessment tools do not adequately capture the dramatic changes in bone microarchitecture, heterogeneity of glucocorticoid exposure, the impact of chronic disease and other osteoporosis risk factors on the assessment of osteoporosis in these individuals. Design: A narrative review is presented, following a systematic search of the literature from 2000 to 2021. Results: Our current appreciation of glucocorticoid-induced osteoporosis (GIO) is focused on older populations, with limited evidence to guide the investigation, risk assessment and treatment in premenopausal women and men less than 50 years. The impact of the underlying chronic disease on secondary osteoporosis in these younger adults is also poorly understood. Conclusion: Through this narrative review, we provide a comprehensive overview of and recommendations for optimising the management of this common cause of secondary osteoporosis younger and older adults.

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Challenges in the diagnosis and management of glucocorticoid-induced osteoporosis in younger and older adults

Abstract

Keywords

UN SDGs

Access to Document

Other files and links

Increasing osteoporosis treatment uptake

Cite this

Challenges in the diagnosis and management of glucocorticoid-induced osteoporosis in younger and older adults

Abstract

Keywords

UN SDGs

Access to Document

Other files and links

Projects

Increasing osteoporosis treatment uptake

Cite this