With great interest, we read the article on long-term corticosteroid therapy by Naganathan et al,1 who reported an increased risk of vertebral deformity associated with the combination of increased age and glucocorticoid use. Osteoporosis and fractures are a major concern in patients receiving long-term glucocorticoid treatment (≥3 months). To estimate which proportion of our patients were receiving osteoporosis prevention during long-term glucocorticoid therapy, we randomly selected the charts of 51 patients who continuously received steroids for at least 3 months (between February 1997 and July 1999). The patients were either inpatients or outpatients (seen in the clinics or in the emergency department) who received steroids either orally or by injection. Any preventive measure (ranging from simple calcium supplementation to hormone replacement therapy) was qualified as "receiving some osteoporosis prevention," as opposed to receiving "no osteoporosis prevention whatsoever." Of the 51 patients in this retrospective study, 35 (68%) were female and 16 (32%) were male. The patients ranged in age from 10 to 95 years (mean age, 61 years), and the median duration of the glucocorticoid treatment was 13 months.
Karcic E, Karcic AA. Osteoporosis and Fracture Risk Prevention in Long-term Glucocorticoid Therapy. Arch Intern Med. 2001;161(14):1780. doi: