Corticosteroid-Induced Osteoporosis in Daily Practice: Pathophysiology, Clinical Importance, Prevention and Intervention Strategies

Abstract

Glucocorticoid-induced osteoporosis is a serious disease that strikes millions of people world-wide every year. Nevertheless much debate is still going on about the preferred strategies to be followed and the magnitude of the problem. Therefore, the first aim of this thesis was to review the current strategies to identify the patient at risk and the options available for prevention and treatment of this serious skeletal disease. In addition we tried to obtain insight in the magnitude of the population at risk in The Netherlands. We also studied the effects of inhaled glucocorticoids on bone mineral density and markers of bone turnover. The second aim was focused on the prevention and treatment of glucocorticoid-induced osteoporosis. First of all the acute effect of etidronate on markers of bone turnover was studied in glucocorticoid treated patients. Subsequently, in two separate studies the effects of etidronate in the prevention and treatment of glucocorticoid-induced osteoporosis was investigated