Glucocorticoid-Induced Osteoporosis: New Guidelines for Early Prevention and Treatment

Oral glucocorticoids (GCs) are widely prescribed, with approximately 1–2% of the adult population receiving them for conditions such as rheumatoid arthritis, asthma, inflammatory bowel disease, lupus, and multiple sclerosis. However, even at low daily doses, prolonged GC therapy is associated with a rapid and significant increase in fracture risk. Up to 30–50% of treated patients develop glucocorticoid-induced osteoporosis (GIOP), making it the most common cause of secondary osteoporosis.

In this lecture, Professor Julien Paccou presents the latest recommendations for the prevention and treatment of GIOP in adults. The updated guidelines highlight early fracture risk assessment at glucocorticoid initiation, evaluation of clinical risk factors and bone mineral density (BMD), recognition of dose- and duration-dependent risk, and timely initiation of anti-osteoporosis therapy in patients at moderate to high risk.
 

Key Learning Objectives of this lecture include:

• Understanding the epidemiology and pathophysiology of GIOP
• Identify patients at risk of GIOP early, using clinical risk factors, glucocorticoid dose and duration, and BMD assessment.
• Reviewing the latest recommendations for the prevention and treatment of GIOP
• Examining practical management strategies in routine care, including treatment selection, monitoring, and long-term follow-up to reduce fracture risk

Uploaded in March 2026