What Is New in the Treatment of Steroid-Induced Osteoporosis?

Glucocorticoid-induced osteoporosis (GIOP) is a serious complication resulting from longterm steroid treatment. In addition to several nonpharmacologic therapies recommended by the American College of Rheumatology, various pharmacologic therapies, such as calcium, vitamin D, hormone-replacement therapy, calcitonin, and bisphosphonates, can be used to prevent and/or treat GIOP. Bisphosphonates, which are potent inhibitors of bone resorption, are considered the most effective and first-line agents for increasing bone mineral density and decreasing the risk of fracture. Human parathyroid hormone has emerged as a promising agent for the treatment of severe GIOP when used alone or in
combination with a bisphosphonate.

In the fall of 1997, H.R., a 51-year-old white woman, thought she was receiving the optimum treatment for her
pemphigus vulgaris flares—high-dose oral prednisone (100 mg per day).

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