[Steroid induced osteoporosis: prevention and treatment]

Rev Med Interne. 2003 Jun;24(6):384-8. doi: 10.1016/s0248-8663(03)00105-x.
[Article in French]


Purpose: Corticosteroid induced osteoporosis (CIO) is the most frequent complication of long-term corticosteroid therapy, and the most frequent cause of secondary osteoporosis. New data from biological, epidemiological and therapeutic studies provide basis for optimal management of this bone disease.

Main points: Corticosteroids are responsible for both quantitative and qualitative deleterious effects on bone, through their effect on bone cells, mainly on osteoblasts (with both a decrease in osteoblast activity and an increase in apoptosis). Epidemiological studies have shown an increased risk of fractures related to CIO, even for low doses, and during the first 6 months of treatment. Relative risk is 1.3 and 2.6 for peripheral and vertebral fractures respectively. Bone mineral density, measured by dual-energy X-ray absorptiometry, is decreased at spine and hip; the risk of fracture is higher in CIO as compared to post-menopausal osteoporosis, for a similar bone density. Prevention of CIO needs the use of the minimal efficacious dose, and treatment of calcium, vitamin D and gonadal hormones insufficiencies. Patients at risk of fracture, as post-menopausal women with prevalent fractures, should receive a bisphosphonate.

Perspective: It may be possible to reduce the fracture risk in patients on long-term corticosteroid therapy.

Publication types

  • English Abstract
  • Review

MeSH terms

  • Absorptiometry, Photon
  • Adrenal Cortex Hormones / adverse effects*
  • Adrenal Cortex Hormones / therapeutic use
  • Bone Density
  • Humans
  • Osteoporosis / chemically induced*
  • Osteoporosis / drug therapy
  • Osteoporosis / epidemiology
  • Osteoporosis / prevention & control*


  • Adrenal Cortex Hormones