A framework for the development of guidelines for the management of glucocorticoid-induced osteoporosis

Osteoporos Int. 2012 Sep;23(9):2257-76. doi: 10.1007/s00198-012-1958-1. Epub 2012 Mar 21.


This paper provides a framework for the development of national guidelines for the management of glucocorticoid-induced osteoporosis in men and women aged 18 years and over in whom oral glucocorticoid therapy is considered for 3 months or longer.

Introduction: The need for updated guidelines for Europe and other parts of the world was recognised by the International Osteoporosis Foundation and the European Calcified Tissue Society, which set up a joint Guideline Working Group at the end of 2010.

Methods and results: The epidemiology of GIO is reviewed. Assessment of risk used a fracture probability-based approach, and intervention thresholds were based on 10-year probabilities using FRAX. The efficacy of intervention was assessed by a systematic review.

Conclusions: Guidance for glucocorticoid-induced osteoporosis is updated in the light of new treatments and methods of assessment. National guidelines derived from this resource need to be tailored within the national healthcare framework of each country.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Aged
  • Aged, 80 and over
  • Bone Density
  • Bone Density Conservation Agents / therapeutic use*
  • Female
  • Glucocorticoids / adverse effects
  • Humans
  • Male
  • Middle Aged
  • Osteoporosis / chemically induced
  • Osteoporosis / drug therapy*
  • Osteoporosis / epidemiology*
  • Practice Guidelines as Topic*
  • Risk Assessment / methods
  • Risk Factors
  • Treatment Outcome


  • Bone Density Conservation Agents
  • Glucocorticoids