Update on the Treatment of Glucocorticoid-Induced Osteoporosis

Osteoporosis and osteoporotic fracture are one of the most common side effects of glucocorticoid therapy. All patients who are taking any dose of glucocorticoids for over 3 months should have a bone health assessment. After consideration of their clinical risk factors, glucocorticoid dose, bone mineral density measurement, and the Fracture Risk Assessment Tool score, patients can be stratified into low-, moderate-, and high-risk groups. General measures include optimization of calcium and vitamin D intake, reducing glucocorticoid dosage and lifestyle modifications. In patients with moderate to high risk of fracture, pharmacological agents should be prescribed, of which bisphosphonates, denosumab, and teriparatide are the most widely used.