How should bone mineral density be monitored in patients taking prolonged glucocorticoids?
- The guidelines vary somewhat in their recommended frequency for BMD measurement in patients taking chronic glucocorticoids.
- Nearly all agree that BMD should be measured one year after the initiation of steroids, and yearly thereafter.
- However, some guidelines recommend decreasing the frequency of BMD measurement to every two to three years if it remains stable (1-3).
- Grossman J, Gordon R, Ranganath V, et al. American College of Rheumatology Recommendations for the Prevention and Treatment of Glucocorticoid-Induced Osteoporosis. Arthritis Care and Research 2010; 62: 1515-1526. Available online.
- Watts NB, Lewiecki EM, Bonnick SL, Laster AJ, Binkley N, Blank RD, et al. Clinical value of monitoring BMD in patients treated with bisphosphonates for osteoporosis. J Bone Miner Res 2009; 24: 1643-1646.
- Bell KJ, Hayen A, Macaskill P, Irwig L, Craig JC, Ensrud K, et al. Value of routine monitoring of bone mineral density after starting bisphosphonate treatment: secondary analysis of trial data. BMJ 2009; 338: b2266.