2022 American College of Rheumatology Guideline for the Prevention and Treatment of Glucocorticoid‐Induced Osteoporosis
Methodological detailsupdated systematic literature review, GRADE approach, Voting Panel ≥70% consensus
- Updated systematic literature review
- GRADE approach
- Voting Panel ≥70% consensus
Recommendations
As issued by the authors
- strong
Adults beginning or continuing >3 months of GC: initial assessment of fracture risk as soon as possible after GC initiation, with clinical fracture assessment, BMD with vertebral fracture assessment or spinal x-ray, and FRAX if ≥40 years old
- strong
Adults at medium, high or very high fracture risk: pharmacologic treatment
Choice of oral or intravenous bisphosphonates, denosumab or parathyroid hormone analogs by shared decision-making
- conditional
Anabolic agents as initial therapy for those with high and very high fracture risk
Recommendations for special populations: children, organ transplants, people who may become pregnant, very high-dose GC treatment; new recommendations on discontinuation of osteoporosis therapy and sequential therapies
Original publication
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