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Scientific paper - Review paper
Osteoporoza uzrokovana glukokortikoidima
Medicus, 31 (2022), 2 Osteoporoza; 215-222. urn:nbn:hr:184:345180
Novak, Srđan; Mirić, Filip

Institutional repository: Repository of the University of Rijeka, Faculty of Medicine

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Novak, S. & Mirić, F. (2022). Osteoporoza uzrokovana glukokortikoidima. Medicus, 31. (2 Osteoporoza), 215-222. Retrieved from https://urn.nsk.hr/urn:nbn:hr:184:345180

Novak, Srđan and Filip Mirić. "Osteoporoza uzrokovana glukokortikoidima." Medicus, vol. 31, no. 2 Osteoporoza, 2022, pp. 215-222. https://urn.nsk.hr/urn:nbn:hr:184:345180

Novak, Srđan and Filip Mirić. "Osteoporoza uzrokovana glukokortikoidima." Medicus 31, no. 2 Osteoporoza (2022): 215-222. https://urn.nsk.hr/urn:nbn:hr:184:345180

Novak, S. and Mirić, F. (2022) 'Osteoporoza uzrokovana glukokortikoidima', Medicus, 31(2 Osteoporoza), pp. 215-222. Available at: https://urn.nsk.hr/urn:nbn:hr:184:345180 (Accessed 12 May 2024)

Novak S, Mirić F. Osteoporoza uzrokovana glukokortikoidima. Medicus [Internet]. 2022 [cited 2024 May 12];31(2 Osteoporoza):215-222. Available at: https://urn.nsk.hr/urn:nbn:hr:184:345180

S. Novak and F. Mirić, "Osteoporoza uzrokovana glukokortikoidima", Medicus, vol. 31, no. 2 Osteoporoza, pp. 215-222, 2022. [Online]. Available at: https://urn.nsk.hr/urn:nbn:hr:184:345180. [Accessed: 12 May 2024]

Metadata
Title (croatian)Osteoporoza uzrokovana glukokortikoidima
Title (english)Osteoporosis Caused by Glucocorticoids
AuthorSrđan Novak
AuthorFilip Mirić
Author's institutionUniversity of Rijeka
Faculty of Medicine
(Department of Internal Medicine)
Scientific / art field,
discipline and subdiscipline		BIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Internal Medicine
Abstract (croatian)
Glukokortikoidi su i dalje krucijalni lijekovi u mnogim autoimunim i upalnim bolestima te je glukokortikoidima inducirana osteoporoza (GIOP) i dalje najčešći oblik sekundarne osteoporoze. Unutar 3 mjeseca od primjene glukokortikoida dolazi do porasta koštane resorpcije i povećanog rizika za prijelome, poglavito vertebralne, ali i ne-vertebralne. Potrebno je stalno podizanje svijesti o GIOP-u te se kod započinjanja terapije glukokortikoidima preporučuje odrediti mineralnu gustoću kosti. U žena u postmenopauzi i muškarcima starijim od 50 godina koji su izloženi oralnim glukokortikoidima ≥ 3 mjeseca potrebno je odrediti rizik za prijelom putem FRAX upitnika. Za započinjanje liječenja koristi se isti dijagnostički kriterij kao u žena u postmenopauzi (T ≤ −2,5), međutim, predložen je viši prag (tj. T ≤ −1,5) s obzirom na to da gubitak kosti može biti 10 % ili više tijekom prve godine korištenja glukokortikoida. Kalcij i vitamin D najčešće nisu dovoljni za prevenciju osteoporotičnih prijeloma. Lijekovi prvog izbora uglavnom su bisfosfonati (alendronat, risedronat), dok u pojedinim slučajevima, poglavito kod bolesnika koji su već imali prijelom, zbog svog anaboličkog djelovanja i dokazanog smanjenja broja vertebralnih prijeloma u obzir dolazi teriparatid. Kao treća linija liječenja može se primijeniti i denosumab.
Abstract (english)
Glucocorticoids are still seen as essential drugs in many autoimmune and inflammatory diseases, and glucocorticoid-induced osteoporosis (GIOP) is still the most common form of secondary osteoporosis. Within three months of using glucocorticoids, there is an increase in bone resorption and risk of fractures, mainly vertebral but also non-vertebral. It is necessary to constantly raise awareness about GIOP, and determining bone mineral density is recommended before starting glucocorticoid therapy. In postmenopausal women and men over 50 who are exposed to oral glucocorticoids for ≥ 3 months, it is necessary to determine facture risk using the FRAX questionnaire. Treatment uses same diagnostic criteria as for postmenopausal women (T ≤ −2.5), albeit a higher threshold is suggested (T ≤ −1.5), given that bone loss may be 10% or more during the first year of glucocorticoid use. Calcium and vitamin D are usually not sufficient for the prevention of osteoporotic fractures. The drugs of first choice are mainly bisphosphonates (alendronate, risedronate), while in some cases, especially in patients who have already suffered a fracture, teriparatide is considered due to its anabolic effect and proven reduction in the number of vertebral fractures. Denosumab can also be used as a third-line treatment.
Keywords (croatian)
Keywords (english)
Languagecroatian
Languageenglish
Publication typeScientific paper - Review paper
Publication statusPublished
Peer reviewPeer review
Publication versionPublished version
Journal titleMedicus
Numberingvol. 31, no. 2 Osteoporoza, pp. 215-222
p-ISSN1330-013X
e-ISSN1848-8315
URN:NBNurn:nbn:hr:184:345180
Publication2022
Document URLhttps://hrcak.srce.hr/291563
Type of resourceText
Access conditionsOpen access
Terms of useLicence Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) icon
Created on2023-01-19 19:45:37