Steroid-Induced Osteoporosis; At a Glance | Biomed Grid

Due to its strong immunosuppressive effects, steroids are a valuable group of drugs and are widely used in the treatment of inflammatory and autoimmune diseases. With the discovery of cortisone and cortisol in the 1930s, synthetic derivatives of glucocorticoids are used successfully in many fields of medicine such as rheumatology, allergy, lung diseases, dermatology, hematology [1], Glucocorticoids (GC) in the treatment of many inflammatory conditions plays an important role. Nowadays steroids major reasons for its use; rheumatologic causes such as rheumatoid arthritis, polymyalgia rheumatica, asthma and chronic obstructive pulmonary disease. It has been reported that oral steroid use in the population is between 0.5-0.9%. The use of GC in the 70-79 age group is approximately 2.5%. [2]. During chronic use of steroids, well-known side effects such as diabetes, osteoporosis, myopathy, cataract, hypothalamic-pituitary-adrenal axis suppression, susceptibility to infections are seen. In addition, lipodystrophy and neuropsychic disorders are the most common side effects [3, 4]. Steroid osteoporosis, the most common cause of secondary osteoporosis and it ranks first in iatrogenic osteoporosis and before the age of 50 years [5]. Studies have shown that oral GCs are both short and long-time use leads to bone loss and increased risk of fracture [6, 7]. This loss is closely related to the cumulative dose and duration, and it has been shown that even a prednisolone dose of <5 mg per day may increase the risk of fracture [8]. In terms of the relationship between fracture risk and GC dose, epidemiological studies have shown an increase in fracture risk even in low doses of 2.5-5 mg prednisone per day. There is a dose-dependent increase in fracture incidence. The risk of fracture appears to be more related to the daily dose than the cumulative dose; this may be explained by the difficulty in accurately calculating the cumulative dose [9]. More than 10% of patients undergoing long-term GC treatment have clinical fractures, and 30-40% have signs of radiological vertebral fractures [10, 11].