Journal of Bone Metabolism (대한골대사학회지)

The Korean Society for Bone and Mineral Research (대한골대사학회)
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Korean Guideline for the Prevention and Treatment of Glucocorticoid-induced Osteoporosis

  • Park, So Young (Division of Endocrinology and Metabolism, Department of Internal Medicine, Kyung Hee University Hospital) ;
  • Gong, Hyun Sik (Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • Kim, Kyoung Min (Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • Kim, Dam (Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Kim, Ha Young (Division of Endocrinology, Department of Internal Medicine, Wonkwang University Sanbon Hospital, Wonkwang University School of Medicine) ;
  • Jeon, Chan Hong (Division of Rheumatology, Department of Internal Medicine, Soonchunhyang University Hospital) ;
  • Ju, Ji Hyeon (Division of Rheumatology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Lee, Shin-Seok (Department of Rheumatology, Chonnam National University Medical School and Hospital) ;
  • Park, Dong-Ah (Division of Healthcare Technology Assessment Research, National Evidence-Based Healthcare Collaborating Agency) ;
  • Sung, Yoon-Kyoung (Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases) ;
  • Kim, Sang Wan (Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul National University College of Medicine, Boramae Medical Center)
  • Received : 2018.07.13
  • Accepted : 2018.08.10
  • Published : 2018.11.30
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Abstract

Background: To develop guidelines and recommendations to prevent and treat glucocorticoid (GC)-induced osteoporosis (GIOP) in Korea. Methods: The Korean Society for Bone and Mineral Research and the Korean College of Rheumatology have developed this guideline based on Guidance for the Development of Clinical Practice Guidelines ver. 1.0 established by the National Evidence-Based Healthcare Collaborating Agency. This guideline was developed by adapting previously published guidelines, and a systematic review and quality assessment were performed. Results: This guideline applies to adults aged ${\geq}19years$ who are using or plan to use GCs. It does not include children and adolescents. An initial assessment of fracture risk should be performed within 6 months of initial GC use. Fracture risk should be estimated using the fracture-risk assessment tool (FRAX) after adjustments for GC dose, history of osteoporotic fractures, and bone mineral density (BMD) results. All patients administered with prednisolone or an equivalent medication at a dose ${\geq}2.5mg/day$ for ${\geq}3months$ are recommended to use adequate calcium and vitamin D during treatment. Patients showing a moderate-to-high fracture risk should be treated with additional medication for osteoporosis. All patients continuing GC therapy should undergo annual BMD testing, vertebral X-ray, and fracture risk assessment using FRAX. When treatment failure is suspected, switching to another drug should be considered. Conclusions: This guideline is intended to guide clinicians in the prevention and treatment of GIOP.

Keywords

References

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