Glucocorticoid Induced Osteoporosis Management

Glucocorticoid-induced osteoporosis represents the most prevalent form of secondary bone loss, driven by rapid osteoblast apoptosis, suppressed bone formation, and transiently elevated osteoclast-mediated resorption. Skeletal deterioration occurs rapidly within the first three months of therapy, independent of bone mineral density, necessitating early risk stratification with FRAX and Vertebral Fracture Assessment. Management mandates immediate daily calcium and vitamin D optimization alongside prompt initiation of systemic pharmacotherapy for individuals at high fracture risk. Bone-forming anabolic agents demonstrate superior efficacy in restoring microarchitecture and reducing fracture incidence compared to standard antiresorptives in this low-bone-turnover state.