The epidemiology indicates doubling of low-impact fractures (vertebral, hip, rib, distal forearm, shoulder) in patients treated with glucocorticoids as compared with healthy men and women. The main mechanism of glucocorticoid induced osteoporosis is due to suppression of new bone formation.
Treatment decisions should include main clinical risk factors according to the WHO recommendations. Although the bone anabolic therapy is a causal one, a sequential use of bone anabolic and antiresorptive therapies is required for long term treatment of glucocorticoid induced osteoporosis.