Understanding Glucocorticoid-induced Osteoporosis: Causes, Effects and Management

Long-term glucocorticoid therapy often results in a serious and common complication known as glucocorticoid-induced osteoporosis (GIOP). This condition is marked by accelerated bone degradation, reduced bone formation and a higher risk of fractures. This article delves into the fundamental mechanisms underlying GIOP, emphasising how glucocorticoids alter bone metabolism and various patient-specific risk factors. The comprehensive review covers the aetiology, consequences and current treatment strategies for GIOP, discussing established pharmacological interventions such as bisphosphonates, anti-receptor activator of NF-KB ligand (RANKL) antibodies and selective oestrogen receptor modulators (SERMs), along with promising new therapies like antisclerostin antibodies. Additionally, this article highlights the importance of nonpharmacological measures, including lifestyle changes, smoking cessation, alcohol moderation and engaging in resistance exercises, as essential components of a comprehensive treatment strategy. Evidence-based recommendations from expert guidelines aim to enhance patient care by improving bone density, preventing fractures and boosting overall health and quality of life for individuals undergoing glucocorticoid therapy. By adopting a multifaceted approach, the management of GIOP can be significantly improved, leading to better outcomes for affected patients.