The Pharmaceutical Journal
Vol 270 No 7234 p142
1 February 2003

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New guidelines recommend bone-protective therapy

Patients at high risk of glucocorticoid-induced osteoporosis — those aged 65 years and over, and those who have already had a fracture caused by fragile bones — should be advised to start bone-protective therapy at the same time as starting glucocorticoids.

This is one recommendation included in new guidelines launched earlier this week by the Royal College of Physicians, the National Osteoporosis Society and the Bone and Tooth Society of Great Britain. The guidelines also recommend that other patients taking glucocorticoids should have their bone mineral density measured with dual energy X-ray absorptiometry.

Measures listed in the guidelines that should be taken to reduce bone loss include reduction of glucocorticoid doses to a minimum, consideration of other formulations or ways of administering the drug and the use of alternative immunosuppressive agents.

Good nutrition, an adequate dietary calcium intake and appropriate physical activity should be encouraged, and tobacco use and alcohol misuse avoided, the guidelines state.

Copies of "Glucocorticoid-induced osteoporosis: guidelines for prevention and treatment" are available priced £15 from the Royal College of Physicians publications department (020 7935 1174 ext 254).