Principles of management of patients with glucocorticoid osteoporosis
I.B. Bashkova¹, I.V. Madyanov<sup>1,2

1</sup> Ulyanov Chuvash State University, Cheboksary
² Republican Clinical Hospital, Cheboksary

Osteoporosis (OP) and related bone fractures are one of the serious complications of oral glucocorticoid (GC) therapy. GCs have a direct effect on bone tissue cells. The loss of bone mass is most pronounced in the first 3–6 months fr om the start of the GC regimen, in the future its decline occurs more slowly, but it continues during the entire period of hormonal therapy. A decrease in bone mineral density inevitably leads to an increased risk of osteoporotic fractures. The article reflects the modern approaches to the prevention and treatment of glucocorticoid OP. Detection criteria among patients receiving GCs, persons with a high risk of developing glucocorticoid OP are presented for the purpose of timely and adequate primary prevention of osteoporotic fractures. The first-line drugs are bisphosphonates and teriparatide. Considering that GSs contribute to the metabolic disturbance of vitamin D, in particular, to the reduction of calciferol hydroxylation processes, an emphasis is placed on the expediency of using active vitamin D metabolites in a comprehensive treatment of OP, wh ere the preference is given to alfacalcidol. It has been shown that alfacalcidol has demonstrated its effectiveness as a therapy of glucocorticoid OP.

Key words: glucocorticoids, glucocorticoid osteoporosis, fractures, vitamin D, active metabolites of vitamin D, alfacalcidol.
For citation: Bashkova I.B., Madyanov I.V. Principles of management of patients with glucocorticoid osteoporosis // RMJ. 2018. № 12(II). P. 99–102.