Intended for healthcare professionals

Rapid response to:


Osteoporosis experts launch guidance to fill gaps left by NICE

BMJ 2008; 337 doi: (Published 21 October 2008) Cite this as: BMJ 2008;337:a2204

Rapid Response:

Advances in glucocorticoid induced osteoporosis ( GIOP)

The association of glucosorticoid induced osteoporosis (GIOP) is well
known since 1932 .This is the most common cause of secondary oetoporosis
.There is a bone loss of more than 30 percent in the first few months of
starting steroids. Antiresorptive agents like bisphosphonate have a clear
prognostic role. Health provider should recognise the recommendation for
treatment with bone risk estimation scale – FRAX. There is no doubt that
this reduces the incidence of fracture .However there still remains a
considerable variation in individual practises and an underutilisation of
DEXA scanning .The other novel treatment are –
pamidronate,treiparatide.There is a proven role of receptor activated
nuclear factor kappa B ligand osteoprotogenin system (1) which will lead
to better therapies .

1.Reid LR et al .Prevention of glucocorticoid-induced oetoporosis .Journal
of bone and mineral research.June 1990 vol./is.5/6 (619-23).

Competing interests:
None declared

Competing interests: No competing interests

11 January 2010
Dr Kaushik Sanyal
Specialist Registrar , Departmentof Rheumatology
Kingston Hospital NHS Trust ,Kingston-upon-Thames