Oral corticosteroids
Risk of fragility fracture is more than doubled for people taking oral
corticosteroid (OCS) drugs. The main reason is believed to be the effect
of OCS on osteoblasts. OCS inhibit osteoblast maturation, secretion
and transformation into osteocytes. They also promote early death of
osteoblasts and osteocytes. High-dose, long-term OCS therapy causes
up to 27 per cent bone density loss within six months.20
For younger adults and premenopausal women, daily dose is important
in determining outcome for bones — the higher the dose,
the greater the risk. But for older adults, even small doses of OCS will
lead to loss of bone density. For all age groups, the impact of OCS is
greatest on trabecular bone, where the micro architecture of the bone
is altered so it becomes thinner and loses integrity, greatly increasing
fracture risk.20 Ongoing bone loss for people taking OCS can be reduced,
although not prevented, by taking calcium and vitamin D supplements.
Other medications that increase risk of osteoporosis include proton
pump inhibitors (eg omeprazole), lithium, anticonvulsants, heparin
Oral corticosteroidsRisk of fragility fracture is more than doubled for people taking oralcorticosteroid (OCS) drugs. The main reason is believed to be the effectof OCS on osteoblasts. OCS inhibit osteoblast maturation, secretionand transformation into osteocytes. They also promote early death ofosteoblasts and osteocytes. High-dose, long-term OCS therapy causesup to 27 per cent bone density loss within six months.20For younger adults and premenopausal women, daily dose is importantin determining outcome for bones — the higher the dose,the greater the risk. But for older adults, even small doses of OCS willlead to loss of bone density. For all age groups, the impact of OCS isgreatest on trabecular bone, where the micro architecture of the boneis altered so it becomes thinner and loses integrity, greatly increasingfracture risk.20 Ongoing bone loss for people taking OCS can be reduced,although not prevented, by taking calcium and vitamin D supplements.Other medications that increase risk of osteoporosis include protonpump inhibitors (eg omeprazole), lithium, anticonvulsants, heparin
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