| [ Summary ] |
The 2014 revised Japanese guidelines on the management and treatment of glucocorticoid-induced osteoporosis indicated that age, the glucocorticoid dose, lumbar bone mineral density (BMD), and prior fragility fractures were predictive factors for future fracture risk, and each factor was scored according to specific cutoff values. Since an age of 65 years or older, a prednisolone dose of 7.5 mg/day or more, and a history of fragility fractures have been found to be independent risk factors for future fractures, initiation of drug therapy can be decided more easily without evaluation of BMD by dual-energy X-ray absorptiometry when one of these risk factors exists. In the guidelines, alendronate and risedronate are recommended as the first-line treatments; and teriparatide (rDNA origin), ibandronate, alfacalcidol, and calcitriol are recommended as alternative options. |