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Lenore Buckley, Gordon Guyatt, Howard A Fink, Michael Cannon, Jennifer Grossman, Karen E Hansen, Mary Beth Humphrey, Nancy E Lane, Marina Magrey, Marc Miller, Lake Morrison, Madhumathi Rao, Angela Byun Robinson, Sumona Saha, Susan Wolver, Raveendhara R Bannuru, Elizaveta Vaysbrot, Mikala Osani, Marat Turgunbaev, Amy S Miller, Timothy McAlindon
OBJECTIVE: To develop recommendations for prevention and treatment of glucocorticoid-induced osteoporosis (GIOP). METHODS: We conducted a systematic review to synthesize the evidence for the benefits and harms of GIOP prevention and treatment options. The Grading of Recommendations Assessment, Development and Evaluation methodology was used to rate the quality of evidence. We used a group consensus process to determine the final recommendations and grade their strength...
August 2017: Arthritis & Rheumatology
Willem F Lems
Until recently, patients with rheumatoid arthritis (RA) were treated with monotherapy using conventional drugs such as sulfasalazine, antimalarials, intramuscular gold and methotrexate, which often leads to persistent arthritis, loss of functional capacity and decreased quality of life. The use of high-dose glucocorticoids (GCs) and active RA are both associated with generalised bone loss and fractures, while GCs have a strong immunosuppressive effect. With the introduction of very effective tumour-necrosis factor-blockers and other biologics, clinical remission is a realistic target in around half of the early patients with RA; the same appears true for the use of methotrexate with chronic low dose or initially high-dose GCs...
2015: RMD Open
Benjamin Z Leder, Joy N Tsai, Alexander V Uihlein, Paul M Wallace, Hang Lee, Robert M Neer, Sherri-Ann M Burnett-Bowie
BACKGROUND: Unlike most chronic diseases, osteoporosis treatments are generally limited to a single drug at a fixed dose and frequency. Nonetheless, no approved therapy is able to restore skeletal integrity in most osteoporotic patients and the long-term use of osteoporosis drugs is controversial. Thus, many patients are treated with the sequential use of two or more therapies. The DATA study showed that combined teriparatide and denosumab increased bone mineral density more than either drug alone...
September 19, 2015: Lancet
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