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Corticosteroid Associated Osteoporosis

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1. Corticosteroid Associated Osteoporosis

Corticosteroid Associated Osteoporosis Corticosteroid Associated Osteoporosis Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 (...) Corticosteroid Associated Osteoporosis Corticosteroid Associated Osteoporosis Aka: Corticosteroid Associated Osteoporosis , Osteoporosis Secondary to Corticosteroid Use , Steroid-Related Bone Mineral Density Loss , Glucocorticoid Induced Osteoporosis From Related Chapters II. Pathophysiology Bone density decreases the most in the first 3-6 months of oral steroid use III. Risk Factors: Osteoporosis on long-term Corticosteroids More than 10% of those on chronic steroids will have a steroid-induced osteoporotic

2018 FP Notebook

2. Bisphosphonates for the prevention of osteoporosis in patients treated with systematic corticosteroids: a review of the clinical evidence and guidelines

). 2011 Authors' conclusions Evidence from three systematic reviews and seven randomized controlled trials suggested that bisphosphonates prevent bone loss associated with use of oral corticosteroids. However, one systematic review and one randomized controlled trial found that the reduction in non-vertebral fractures with bisphosphonates was not statistically significant. Project page URL Indexing Status Subject indexing assigned by CRD MeSH Adrenal Cortex Hormones; Diphosphonatess; Osteoporosis (...) Bisphosphonates for the prevention of osteoporosis in patients treated with systematic corticosteroids: a review of the clinical evidence and guidelines Bisphosphonates for the prevention of osteoporosis in patients treated with systematic corticosteroids: a review of the clinical evidence and guidelines Bisphosphonates for the prevention of osteoporosis in patients treated with systematic corticosteroids: a review of the clinical evidence and guidelines Canadian Agency for Drugs

2011 Health Technology Assessment (HTA) Database.

3. Inhaled corticosteroids can reduce osteoporosis in female patients with COPD (PubMed)

Inhaled corticosteroids can reduce osteoporosis in female patients with COPD Whether the use of inhaled corticosteroids (ICSs) in patients with COPD can protect from osteoporosis remains undetermined. The aim of this study is to assess the incidence of osteoporosis in patients with COPD with ICS use and without.This is a retrospective cohort and population-based study in which we extracted newly diagnosed female patients with COPD between 1997 and 2009 from Taiwan's National Health Insurance (...) ). The higher ICS dose is associated with lower risk of osteoporosis (0 mg to ≤20 mg, HR: 0.84, 95% CI: 0.69-1.04; >20 mg to ≤60 mg, HR: 0.78, 95% CI: 0.59-1.04; and >60 mg, HR: 0.72, 95% CI: 0.55-0.96; P for trend =0.0023) after adjusting for age, income, and medications. The cumulative osteoporosis probability significantly decreased among the ICS users when compared with the nonusers (P<0.001).Female patients with COPD using ICS have a dose-response protective effect for osteoporosis.

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2016 International journal of chronic obstructive pulmonary disease

4. Different durations of corticosteroid therapy for exacerbations of chronic obstructive pulmonary disease. (PubMed)

Different durations of corticosteroid therapy for exacerbations of chronic obstructive pulmonary disease. Current guidelines recommend that patients with acute exacerbations of chronic obstructive pulmonary disease (COPD) should be treated with systemic corticosteroid for seven to 14 days. Intermittent systemic corticosteroid use is cumulatively associated with adverse effects such as osteoporosis, hyperglycaemia and muscle weakness. Shorter treatment could reduce adverse effects.To compare (...) the efficacy of short-duration (seven or fewer days) and conventional longer-duration (longer than seven days) systemic corticosteroid treatment of adults with acute exacerbations of COPD.Searches were carried out using the Cochrane Airways Group Specialised Register of Trials, MEDLINE and CENTRAL (Cochrane Central Register of Controlled Trials) and ongoing trials registers up to March 2017.Randomised controlled trials comparing different durations of systemic corticosteroid defined as short (i.e. seven

2018 Cochrane

5. Osteoporosis

patients in the statin and non-statin cohorts, respectively. Main Outcome Measures: Hazard ratios (HRs) for post-stroke osteoporosis , hip fracture, and vertebral fracture (together, the primary outcome) were calculated using Cox proportional hazards regression models according to the status of statin use. Results: Post-stroke statin use was associated 2018 15. Interventions to prevent and treat corticosteroid-induced osteoporosis and prevent osteoporotic fractures in Duchenne muscular dystrophy (...) ’ conclusions are generally suitably cautious but it remains unclear which of the treatments for osteoporosis most effective. Authors' objectives To assess the effectiveness of postmenopausal osteoporosis therapies in reducing fracture risk. Searching MEDLINE (from 1950), EMBASE (from 1980), CINAHL and Cochrane Central Register of Controlled Trials 2014 14. Statin use is associated with decreased osteoporosis and fracture risks in stroke patients. Context: Post-stroke osteoporosis and consequent fracture

2018 Trip Latest and Greatest

6. The Prevention of glucocorticoid?induced osteoporosis in patients with immune thrombocytopenia receiving steroids: Good Practice Paper

, 306 – 311 . Homik, J. , Suarez‐Almazor, M.E. , Shea, B. , Cranney, A. , Wells, G. & Tugwell, P. ( 2000 ) Calcium and vitamin D for corticosteroid‐induced osteoporosis . Cochrane Database Systematic Review , 2000 , CD000952 . Honkanen, R. , Tuppurainen, M. , Kroger, H. , Alhava, E. & Puntila, E. ( 1997 ) Associations of early premenopausal fractures with subsequent fractures vary by sites and mechanisms of fractures . Calcified Tissue International , 60 , 327 – 331 . Horowitz, M. , Wishart, J.M (...) Committee General Haematology Task Force, the BSH Guidelines Committee and the General Haematology Sounding Board of BSH. It was also placed on the members section of the BSH website for comment. The manuscript has also been reviewed by The ITP Support Association, although this organisation does not necessarily approve or endorse the contents. Introduction Glucocorticoids are a standard first line treatment for immune thrombocytopenia (ITP) and are an important risk factor for osteoporosis

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2019 British Committee for Standards in Haematology

7. Long-Term Drug Therapy and Drug Holidays for Osteoporosis Fracture Prevention: A Systematic Review

drug continuation versus discontinuation ES-14 Table 1. U.S. FDA approved drugs used for osteoporosis treatment and prevention 3 Table 2. PICOTS 7 Table 3. Harms evaluated for possible association with long-term osteoporosis drug therapy 11 Table 4. Study inclusion criteria 14 Table 5. Eligible publications that compared long-term osteoporosis drug use versus control or osteoporosis drug continuation versus discontinuation (placebo drug holiday) and reported on risk of incident fractures (...) and microarchitectural deterioration of bone, leading to bone fragility and increased risk of fracture. 1 Osteoporosis affects more than 10 million U.S. adults aged 50 years or older. 2 About two million U.S. adults experience an osteoporotic or other low- or no-trauma fracture each year. 3 These fractures frequently cause pain, disability, and impaired quality of life; 4, 5 and hip and clinical vertebral fractures, specifically, are associated with increased mortality. 5, 6 Because risk of most fractures rises

2019 Effective Health Care Program (AHRQ)

8. Corticosteroids

disease (COPD) should be treated with systemic corticosteroid for seven to 14 days. Intermittent systemic corticosteroid use is cumulatively associated with adverse effects such as osteoporosis, hyperglycaemia and muscle weakness. Shorter treatment could reduce adverse effects (...) . OBJECTIVES: To compare the efficacy of short-duration (seven or fewer days) and conventional longer-duration (longer than seven days) systemic corticosteroid treatment of adults with acute exacerbations of COPD. SEARCH (...) with corticosteroid injections or non-electrotherapeutical physiotherapy: a systematic review. BMJ Open 2013;3(10):e003564 Link: Published: 29 October (...) 2013 Evidence cookie says… Corticosteroid injections should be generally avoided for tennis elbow (lateral epicondylitis). They are associated with: increased likelihood of improvement in the short term (4-12 weeks) reduced likelihood of improvement in the intermediate (26 weeks) and long term (52 weeks) Clinical scenario Jack, a 45-year-old business

2018 Trip Latest and Greatest

9. Src siRNA prevents corticosteroid-associated osteoporosis in a rabbit model. (PubMed)

Src siRNA prevents corticosteroid-associated osteoporosis in a rabbit model. In an established steroid-associated osteonecrosis (SAON) rabbit model we found recently that blockage Src by siRNA could improve reconstructive repair of osteonecrosis via enhancing osteogenesis and inhibiting bone resorption. The current study investigated if blocking Src was able to prevent steroid-associated osteoporosis (SAOP) in the same SAON animal model. Rabbits were treated with pulsed lipopolysaccharide (LPS (...) ) and corticosteroid methylprednisolone (MPS). At 2, 4, and 6weeks after induction, Src siRNA, control siRNA and saline were intramedullary injected into proximal femur, respectively. Two fluorescent dyes xylenol orange and calcein green were injected before sacrificing the animals for in vivo labeling of the newly formed bone. At week 6 after induction, proximal femora of rabbits were dissected for micro-CT and histological analysis. Results showed significant bone loss in the metaphysis of femoral head

2015 Bone

10. Interest of Denosumab Treatment in Osteoporosis Associated to Systemic Mastocytosis

Interest of Denosumab Treatment in Osteoporosis Associated to Systemic Mastocytosis Interest of Denosumab Treatment in Osteoporosis Associated to Systemic Mastocytosis - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before (...) adding more. Interest of Denosumab Treatment in Osteoporosis Associated to Systemic Mastocytosis (DenosuMast) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. of clinical studies and talk to your health care provider before participating. Read our for details. ClinicalTrials.gov Identifier: NCT03401060 Recruitment Status : Recruiting First Posted : January

2018 Clinical Trials

11. Anabolic Therapies for Osteoporosis in Postmenopausal Women: Effectiveness and Value

is to prevent the fragility fractures associated with osteoporosis: most commonly hip, spine, and wrist fractures. There are two emerging anabolic (i.e., bone-building) therapies for osteoporosis: abaloparatide (Tymlos™, Radius Health, Inc.) and romosozumab (Amgen, Inc. and UCB, Inc.). The only other FDA-approved anabolic agent is teriparatide (Forteo®, Eli Lilly and Co.), which acts through a similar mechanism to abaloparatide. All other agents approved by the United States Food and Drug Administration (...) in a location associated with osteoporosis (i.e., vertebra, hip). A fragility fracture is a fracture from a low-energy injury that would not normally be expected to result in a broken bone, such as a fall from standing height or less. The most common fractures associated with osteoporosis are vertebral (27%), wrist (19%), hip (14%), and pelvic (7%). 3 ©Institute for Clinical and Economic Review, 2017 Page ES2 Evidence Report – Anabolic Therapies for Osteoporosis Return to Table of Contents Many

2017 California Technology Assessment Forum

12. Cement injections to treat spinal compression fractures from osteoporosis can reduce short term pain

Cement injections to treat spinal compression fractures from osteoporosis can reduce short term pain Cement injections to treat spinal compression fractures from osteoporosis can reduce short term pain Discover Portal Discover Portal Cement injections to treat spinal compression fractures from osteoporosis can reduce short term pain Published on 13 December 2016 doi: Injecting cement into osteoporotic spinal fractures within six weeks reduces pain in the first few months and disability six (...) centres. Share your views on the research. Why was this study needed? Worldwide, an estimated 1.4 million people with osteoporosis experience vertebral fractures. Most osteoporotic vertebral fractures are treated conservatively with painkillers, bed rest and mobility exercises as function improves. However, painkillers and prolonged bed rest can both have adverse effects in older people. Vertebroplasty involves injecting special cement into the broken vertebrae to relieve pain and strengthen the bone

2019 NIHR Dissemination Centre

13. American College of Rheumatology Guideline for the Prevention and Treatment of Glucocorticoid-Induced Osteoporosis

American College of Rheumatology Guideline for the Prevention and Treatment of Glucocorticoid-Induced Osteoporosis ARTHRITIS & RHEUMATOLOGY Vol. 69, No. 8, August 2017, pp 1521–1537 DOI 10.1002/art.40137 V C 2017, American College of Rheumatology SPECIAL ARTICLE 2017 American College of Rheumatology Guideline for the Prevention and Treatment of Glucocorticoid-Induced Osteoporosis Lenore Buckley, 1 Gordon Guyatt, 2 Howard A. Fink, 3 Michael Cannon, 4 Jennifer Grossman, 5 Karen E. Hansen, 6 Mary (...) - ter, Virginia Beach, Virginia; 5 Jennifer Grossman, MD: University of California, Los Angeles; 6 Karen E. Hansen, MD, MS, Sumona Saha, MD: University of Wisconsin, Madison; 7 Mary Beth Humphrey, MD, PhD: Oklahoma University Health Sciences Center, Oklahoma City; 8 Nancy E. Lane, MD: University of California Davis, Sacramento; 9 Marina Magrey, MD: Case Western Reserve University, Metro- Health System, Cleveland, Ohio; 10 Marc Miller, MD: Rheumatology Associates, Portland, Maine; 11 Lake Morrison

2017 American College of Rheumatology

14. Diagnosis and Management of Osteoporosis

Vertebral compression fracture or osteopenia identified on radiography o Parental hip fracture o Prolonged use of glucocorticoids** o Use of other high risk medications † o Rheumatoid arthritis, malabsorption syndrome, other disorders strongly associated with osteoporosis o Current smoker o High alcohol intake (>3 units/day) o Major weight loss (10% below their body weight at age 25) ? Discuss the limited value of a BMD test with all men and women >50 years of age who are requesting BMD test (...) the individual’s risk is raised to the next risk level (i.e., from low to moderate or from moderate to high). When both clinical factors are present, the patient is considered at high risk of fracture, regardless of BMD. 12 The Osteoporosis Canada 10 year Fracture Risk Assessment Tool, based on the Canadian 2010 Osteoporosis Guidelines and the Canadian Association of Radiologists and Osteoporosis Canada (CAROC) system provides physicians with a calculator to determine a patient’s 10 year risk of fracture

2016 Toward Optimized Practice

15. Treatment of Low Bone Density or Osteoporosis to Prevent Fractures in Men and Women: A Clinical Practice Guideline Update from the American College of Physicians

-quality evidence that estrogen therapy was associated with reduced risk for vertebral, nonvertebral, and hip fractures in postmenopausal women ( , ). Studies included in the 2008 guideline focused on postmenopausal women or those with low bone density as opposed to the newer data, which focused on postmenopausal women with established osteoporosis. Calcium or Vitamin D Moderate-quality evidence showed that the overall effect of calcium or vitamin D alone on fracture risk is uncertain. Studies showed (...) %) ( ). Denosumab has also been associated with rash/eczema (OR, 1.96 [CI, 1.46 to 2.66]) ( , , ). A post hoc analysis of the open-label extension of FREEDOM (Fracture Reduction Evaluation of Denosumab in Osteoporosis every 6 Months) confirmed 2 events of atypical femoral fracture and 8 events of osteonecrosis of the jaw through 8 years of denosumab therapy ( ). Teriparatide High-quality evidence showed that teriparatide is associated with mild upper gastrointestinal symptoms (OR, 3.26 [CI, 2.82 to 3.78

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2017 American College of Physicians

16. A Study Comparing Corticosteroids Alone Versus Corticosteroids and Extracorporal Photopheresis (ECP) as First-line Treatment of Standard II Acute Graft-versus-host Disease

host-disease remains a major cause of morbidity and mortality after allogeneic hematopoietic stem cell transplantation. The incidence of grade II to IV acute GVHD ranges from 30 to 50% of the patients transplanted. Steroids remain the standard first line treatment for acute GVHD. Prolonged exposure to steroids is associated to increased risk of infections and of osteoporosis, osteonecrosis and alteration of growth in children. Thus, reducing steroid exposure in order to reduce treatment-related (...) A Study Comparing Corticosteroids Alone Versus Corticosteroids and Extracorporal Photopheresis (ECP) as First-line Treatment of Standard II Acute Graft-versus-host Disease A Study Comparing Corticosteroids Alone Versus Corticosteroids and Extracorporal Photopheresis (ECP) as First-line Treatment of Standard II Acute Graft-versus-host Disease - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search

2018 Clinical Trials

17. Cement injections to treat spinal compression fractures from osteoporosis can reduce short term pain

Cement injections to treat spinal compression fractures from osteoporosis can reduce short term pain Cement injections to treat spinal compression fractures from osteoporosis can reduce short term pain Discover Portal Discover Portal Cement injections to treat spinal compression fractures from osteoporosis can reduce short term pain Published on 13 December 2016 doi: Injecting cement into osteoporotic spinal fractures within six weeks reduces pain in the first few months and disability six (...) centres. Share your views on the research. Why was this study needed? Worldwide, an estimated 1.4 million people with osteoporosis experience vertebral fractures. Most osteoporotic vertebral fractures are treated conservatively with painkillers, bed rest and mobility exercises as function improves. However, painkillers and prolonged bed rest can both have adverse effects in older people. Vertebroplasty involves injecting special cement into the broken vertebrae to relieve pain and strengthen the bone

2018 NIHR Dissemination Centre

18. Osteoporosis and Bone Mineral Density

up medical conditions associated with abnormal BMD Radiologic Procedure Rating Comments RRL* DXA lumbar spine and hip(s) 9 ? QCT lumbar spine and hip 6 ??? DXA distal forearm 5 ? TBS lumbar spine 4 ? QUS calcaneus 2 O SXA distal forearm 2 ? pQCT distal forearm 2 ? X-ray axial skeleton 1 Varies X-ray appendicular skeleton 1 ?? Rating Scale: 1,2,3 Usually not appropriate; 4,5,6 May be appropriate; 7,8,9 Usually appropriate *Relative Radiation LevelACR Appropriateness Criteria ® 2 Osteoporosis (...) . Conditions associated with secondary osteoporosis, such as gastrointestinal malabsorption or malnutrition, sprue, osteomalacia, vitamin D deficiency, endometriosis, acromegaly, chronic alcoholism or established cirrhosis, and multiple myeloma g. Individuals who have had gastric bypass for obesity. The accuracy of DXA in these patients might be affected by obesity. h. Individuals with an endocrine disorder known to adversely affect BMD (eg, hyperparathyroidism, hyperthyroidism, or Cushing syndrome) 2

2016 American College of Radiology

19. Corticosteroid treatment of duchenne muscular dystrophy

the optimal prednisone dose. Prednisone 10 mg/kg/weekend is equally effective over a 12-month period, although long-term outcomes of this alternate regimen remain to be seen. Because of the expectation of significant AEs with corticosteroids, proper informed consent is required, and AEs should be discussed with patients and their families prior to therapy initiation and should be managed proactively. The American College of Rheumatology Task Force osteoporosis guideline recommends calcium and vitamin D (...) Corticosteroid treatment of duchenne muscular dystrophy Practice guideline update summary: Corticosteroid treatment of Duchenne muscular dystrophy | Neurology Advertisement Search for this keyword Main menu User menu Search Search for this keyword The most widely read and highly cited peer-reviewed neurology journal Share February 02, 2016 ; 86 (5) Special Article Practice guideline update summary: Corticosteroid treatment of Duchenne muscular dystrophy Report of the Guideline Development

2016 American Academy of Neurology

20. Corticosteroids and Prophylaxis. What complications should you try to prevent in patients on chronic corticosteroids?

with alendronate: A randomized, double-blind, placebo-controlled study. Arch Dermatol. 2012;148(3):307-314. 11. Kitazaki S, Mitsuyama K, Masuda J, et al. Clinical trial: Comparison of alendronate and alfacalcidol in glucocorticoid-associated osteoporosis in patients with ulcerative colitis. Aliment Pharmacol Ther. 2009;29(4):424-430. 12. Gonnelli S, Rottoli P, Cepollaro C, et al. Prevention of corticosteroid-induced osteoporosis with alendronate in sarcoid patients. Calcif Tissue Int. 1997;61(5):382-385. ht 13 (...) diagnosed with systemic sarcoidosis. The patient is started on prednisone 40mg with the plan to decrease the dose after remission of symptoms, which may take a number of months. What kind of prophylaxis should the patient receive? Corticosteroids are an effective treatment option for a number of diseases spanning many specialties. However, long-term corticosteroid treatment is marred with a number of side effects including hypertension, hyperglycemia, weight gain, adrenal suppression, osteoporosis, [1,2

2013 Clinical Correlations

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