Glucocorticoids, inflammation and bone loss

Published on July 30, 2015   28 min
My name is Christian Roux. I am a professor of Rheumatology in the Paris Descartes University in Paris, France. And the topic today is about bone loss and osteoporosis in patients with inflammatory diseases, receiving glucocorticoids.
Here are my disclosures, related to this talk.
Glucocorticoids are very effective in a number of diseases with acute or chronic inflammation. At any time, roughly 1% of the world population is receiving oral glucocorticoids, and the highest prevalence of use is in patients at the age of 70. That is to say, we are underlying quite high risk of osteoporosis.
Glucocorticoids therapy is the most common cause of secondary osteoporosis. This is a theoretical curve of change in bone strength in patients receiving such a treatment. As you can appreciate, the decrease is rapid and dramatic within the first year, and maybe during the first month after initiating the treatment. And then, this decrease occurs more slowly, there after. This rapid effect is parallel with the risk of fractures, which increases rapidly after the initiation of therapy. And there is a strong rationale for this effect, related to both the underlying effect of inflammation, that we will see on one the slides, but also the effect of steroids on bone through direct or indirect mechanisms.