Current Treatments and New Developments in the Management of Glucocorticoid-induced Osteoporosis

AbstractGlucocorticoids (GCs) are often used for improvement of quality of life, particularly in the elderly, but long-term GC use may cause harm; bone loss and fractures are among the most devastating side effects. Fracture risk is particularly high in patients with a severe underlying disease with an urgent need for treatment with high-dose GCs. Moreover, it is important to realize that these patients suffer from an augmented background fracture risk as these patients have a high presence of traditional risk factors for osteoporosis, such as high age, low body mass index (BMI), smoking and relatives with osteoporosis or hip fractures. It is thus crucial for prevention of osteoporotic fractures to use the lowest dose of GC for a short period of time to prevent fractures. Another important task is optimal treatment of the underlying disease; for instance, fracture risk is higher in patients with active rheumatoid arthritis than in patients in whom rheumatoid arthritis is in remission. Thus, fracture risk is generally highest in the early phase, when GC dosage and the disease activity of the underlying disease are high. Finally, some of the traditional risk factors can be modulated, e.g., smoking and low BMI. Life-style measures, such as adequate amounts of calcium and vitamin D and exercise therapy are also crucial. In some patients, anti-osteoporotic drugs are also indicated. In general, oral bisphosphonates (BPs) are the first choice, because of their efficacy and safety co...
Source: Drugs - Category: Drugs & Pharmacology Source Type: research

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This study aimed to identify biomarkers predictive of bone mineral density (BMD) change at three anatomical sites in ...
Source: Arthritis Research and Therapy - Category: Rheumatology Authors: Tags: Research article Source Type: research
Publication date: Available online 12 July 2019Source: Pharmacological ResearchAuthor(s): Giovanni Orsolini, Angelo Fassio, Maurizio Rossini, Giovanni Adami, Alessandro Giollo, Cristian Caimmi, Luca Idolazzi, Ombretta Viapiana, Davide GattiAbstractBone loss is a typical consequence of Rheumatoid Arthritis (RA). It occurs not only locally, affecting the inflamed joints (erosions), but also systemically, leading to osteopenia and/or overt osteoporosis, with increased risk of fragility fractures. This complication, often underestimated, can worsen the burden of disability in RA patients. Moreover, systemic and local bone loss...
Source: Pharmacological Research - Category: Drugs & Pharmacology Source Type: research
Seventy years after the discovery of their anti-inflammatory properties, glucocorticoids (GCs) remain the mainstay treatment for major allergic and inflammatory disorders, such as atopic dermatitis, asthma, rheumatoid arthritis, colitis, and conjunctivitis, among others. However, their long-term therapeutical administration is limited by major debilitating side effects, e.g., skin atrophy, osteoporosis, Addison-like...
Source: Proceedings of the National Academy of Sciences - Category: Science Authors: Tags: PNAS Plus Source Type: research
The end of another quarter means a new list of FDA-approved drugs for primary care. Which ones should you know about? Click through to find out.  
Source: ConsultantLive - Category: Internal Medicine Authors: Tags: Obesity Opioid Related Disorders Osteoporosis Pregnancy and Birth Psoriasis Rheumatoid Arthritis T2 Diabetes Source Type: news
ConclusionAVI exertes its anti-osteoclastogenic activity both in vitro and in vivo by inhibiting RANKL-induced osteoclast differentiation and function. Thus, our studies demonstrate a potential therapeutic role for AVI in preventing or inhibiting RANKL-mediated osteolytic bone diseases.Graphical abstract
Source: Phytomedicine - Category: Drugs & Pharmacology Source Type: research
AbstractObjectivesMALT1 plays a crucial role in innate and adaptive immune signaling by modulating the threshold for activation of immune cells, including regulatory T ‐cells (Tregs). Therefore, MALT1 is regarded an interesting therapeutic target in several immune‐mediated diseases. Our goal was to examine the role of MALT1 in rheumatoid arthritis (RA).MethodsMALT1 ‐activation was assessed by measuring CYLD‐cleavage in lymphocytes of mice subjected to collagen‐induced arthritis (CIA). The impact of MALT1‐deficiency on arthritis was evaluated by inducing CIA and collagen‐antibody induced arthritis (CAIA) inMal...
Source: Arthritis and Rheumatology - Category: Rheumatology Authors: Tags: Full Length Source Type: research
Berberine coated mannosylated liposomes curtail RANKL stimulated osteoclastogenesis through the modulation of GSK3β pathway via upregulating miR-23a. Int Immunopharmacol. 2019 Jun 28;74:105703 Authors: Sujitha S, Rasool M Abstract Drug-induced microRNAs manifest significant therapeutic approaches; however, such progress in the treatment of osteopathic disorders including osteoporosis and rheumatoid arthritis still remains obscure. Contrarily, non-specific drug delivery, at high doses, increases the risk of side effects and reduces drug therapeutic efficacy. Accordingly, the present study was desi...
Source: International Immunopharmacology - Category: Allergy & Immunology Authors: Tags: Int Immunopharmacol Source Type: research
Conditions:   Rheumatoid Arthritis;   Osteoporosis Intervention:   Diagnostic Test: 14-3-3η Protein assay Sponsor:   Al-Azhar University Recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
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