Osteoporosis: Glucocorticoid-Induced

Question 1

What dose and length of treatment with prednisolone causes a patients risk of osteoporosis to rise significantly?

Answer 1

7.5mg a day for 3 or more months.

Question 2

What is our treatment approach with regard to corticosteroids and osteoporosis?

Answer 2

Anticipatory Bone Protection

I.e. person diagnosed with polymyalgia rheumatica - will need cotricosteroids - then diagnose bone protection.

Question 3

What is the RCP guideline for managing patients with a risk of corticosteroid-induced OP?

Answer 3

1. > 65yrs or previous fragility fracture = bone protection.
2. <65 years –> Offer a bone density scan.
   
   • >0 = reassure
   • 0 to -1.5 = Repeat in 1-3 years.
   • < -1.5 = offer bone protection.

Question 4

What is first line?

What should you make sure patients also has good levels of/ good intake of?

Answer 4

First line is alendronate

They should have adequate be calcium and vitamin D.