We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Review |

Glucocorticoid-Induced Bone Loss in Dermatologic Patients An Update

Brett T. Summey, MD; Gil Yosipovitch, MD
Arch Dermatol. 2006;142(1):82-90. doi:10.1001/archderm.142.1.82.
Text Size: A A A
Published online

Objective  To raise awareness of the new treatment options and current recommendations among dermatologists treating patients with systemic corticosteroids.

Data Sources  MEDLINE peer-reviewed publications.

Study Selection  English language and clinical pertinence to corticosteroid-induced osteoporosis.

Data Extraction  Pertinent information on pathophysiologic, epidemiologic, clinical trial, cost-effectiveness, and treatment option data regarding corticosteroid-induced osteoporosis.

Data Synthesis  Comprehensive summary of published data on the pathophysiologic, epidemiologic, clinical, and treatment data and current practice guidelines regarding corticosteroid-induced osteoporosis; creation of an algorithmic management approach for patients treated with long-term oral corticosteroids.

Conclusions  Glucocorticoid-induced bone loss is the most predictable and debilitating complication of prolonged administration of systemic corticosteroids. Every dermatologist prescribing systemic corticosteroids must be aware of corticosteroid-induced osteoporosis and ensure that every patient is receiving general measures to prevent it. Despite efficacious preventive and therapeutic options, actual implementation of these strategies remains unacceptably low. Based on currently available evidence, the first choice for prevention and treatment of glucocorticoid-induced osteoporosis should be a potent oral bisphosphonate such as alendronate (70 mg/wk) or risedronate sodium (35 mg/wk). For patients with severe osteoporosis or patients with active osteoporotic fractures, the anabolic agent teriparatide (recombinant fragmented parathyroid hormone) should be considered as a first-line option for up to 2 years.

Figures in this Article


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?


Place holder to copy figure label and caption
Figure 1.

Causes of glucocorticoid-induced bone loss. RANKL indicates receptor activator of nuclear factor κB ligand

Graphic Jump Location
Place holder to copy figure label and caption
Figure 2.

Algorithm for prevention and treatment of bone loss. Teriparatide should be considered a first-line treatment for severe osteoporosis and patients with preexisting osteoporotic fractures. IV indicates intravenous. The asterisk indicates that dual-energy x-ray absorptiometry (DEXA) is not required to start treatment, although it is helpful in monitoring the degree of bone loss on a 6- to 12-month basis.

Graphic Jump Location




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

27 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...