In contrast to most other forms of osteoporosis, the major clinical manifestation of corticosteroid induced osteoporosis, in terms of fracture, is at the spine and, to a lesser extent, the ribs. Accordingly, the most important consideration in the selection of therapy for corticosteroid induced osteoporosis is the effect of particular agents on spine bone mineral density. Calcitriol (the active hormonal from of vitamin D) and the bisphosphonates appear to be effective agents in the treatment of corticosteroid induced spinal bone loss.