GLUCOCORTICOIDS ARE used for immunosuppressive or anti-inflammatory treatment of a wide range of diseases, including nephrotic syndrome, asthma, rheumatoid arthritis, polymyalgia rheumatica, various vasculitides, atopic dermatitis, and inflammatory bowel disease. Although glucocorticoids have shown beneficial effects on treating these diseases, long-term glucocorticoid treatment may have severe adverse effects; these side effects include osteoporosis and fracturing, diabetes mellitus, dramatic weight gain, accelerated atherosclerosis, hypertension, and decreased muscle mass and strength (steroid-induced myopathy).1 In fact, the Cushing syndrome that is produced by exogenous steroid treatment can, in some instances, be worse than the disease that is being treated. It has been estimated that the prevalence of vertebral fractures in asthmatic patients who receive oral glucocorticoids for at least 1 year is 11% and that 30% to 35% of patients who take oral glucocorticoids for prolonged periods will experience a vertebral fracture.2 In previous studies, oral prednisone (10-25 mg) that was