Corpus ID: 74382170

Adecuación del tratamiento corticoideo a las guías de práctica clínica. Influencia en la dosis acumulada de corticoides orales y efectos adversos sobre la masa ósea

  title={Adecuaci{\'o}n del tratamiento corticoideo a las gu{\'i}as de pr{\'a}ctica cl{\'i}nica. Influencia en la dosis acumulada de corticoides orales y efectos adversos sobre la masa {\'o}sea},
  author={Alicia Conde Valero and Norberto Ortego Centeno and Jos{\'e} Luis Rivarola Rubio and Pedro Mezquita Raya and Manuel P. Mu{\~n}oz Torres},
Background: In order to minimize the side effects of corticosteroids, and in view of the efficiency of inhaled corticosteroids in asthma treatment, clinical practice guides recommend their use in ideal doses before going on to the oral route. Our hypothesis was that if patients receive oral corticosteroids before exhausting the ideal doses of inhaled corticosteroids, they will receive higher doses of accumulated corticosteroids and this will translate into diminished bone mass. Method: We… 


Corticosteroid-Induced Bone Loss
Many different drugs have been used to prevent osteoporosis in patients receiving long-term corticosteroid therapy, including thiazide diuretics, chole-calciferol (vitamin D) metabolites, bisphosphonates, calcitonin, fluoride, estrogens, anabolic steroids and progesterone.
Bone density in asthmatic patients taking high dose inhaled beclomethasone dipropionate and intermittent systemic corticosteroids.
Asthmatic patients receiving high dose inhaled beclomethasone and intermittent courses of systemic corticosteroids have reduced vertebral bone density, similar in degree to that seen in patients taking high doses inhaled topical cortic Fosteroids and continuous low dose systemic cortICosteroids.
Adverse effects of oral corticosteroids in relation to dose in patients with lung disease
By quantifying the morbidity associated with the use of oral corticosteroids, this study should help to rationalise their long term use.
Use of Inhaled Corticosteroids and Risk of Fractures
  • T. van Staa, H. Leufkens, C. Cooper
  • Medicine
    Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research
  • 2000
It is concluded that users of inhaled corticosteroids have an increased risk of fracture, particularly at the hip and spine, however, this excess risk may be related more to the underlying respiratory disease than to inhaled Corticosteroid.
Glucocorticoid induced osteoporosis
The association between glucocorticoid excess and osteoporosis, first described by Cushing (1 932) in one case with adrenal hyperfunction secondary to a pituitary tumour, has become a significant
Glucocorticoid-induced osteoporosis: pathogenesis and management
The pathogenesis of GC-induced osteoporosis and its prevention and treatment is summarized, with a focus on rheumatoid arthritis patients.
A Histomorphometric Long-Term Longitudinal Study of Trabecular Bone Loss in Glucocorticoid-Treated Patients: Prednisone Versus Deflazacort
A prospective long-term study using histomorphometric analysis of iliac bone confirms that an exponential model accurately describes the trabecular bone loss induced by long- term corticosteroid treatment and demonstrates that deflazacort, at therapeutically effective doses, induces less trabECular bone Loss than prednisone.
Determinants of vertebral mineral density in patients receiving long-term glucocorticoid therapy.
Bone loss was not influenced by sex, age, duration of previous steroid treatment, or diagnosis and was not predictable from biochemical measures of calcium metabolism.
Chronic glucocorticoid therapy-induced osteoporosis in patients with obstructive lung disease.
A review of the current literature regarding the incidence, treatment, and prevention of osteopenia/osteoporosis secondary to chronic GC therapy in adult asthma and COPD patients is presented.
Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: Synopsis of a WHO report
  • J. Kanis
  • Medicine
    Osteoporosis International
  • 2005
There is little evidence that osteoporosis can usefully be tackled by a public health policy to influence risk factors such as smoking, exercise and nutrition, so the selective use of screening techniques will improve the cost-benefit ratio of intervention.