Glucocorticoids are used widely in a range of medical specialities, but their main limitation is an adverse impact on bone. Although physicians are increasingly aware of these deleterious effects, the marked variation in susceptibility between individuals makes it difficult to predict who will develop skeletal complications with these drugs. Although the mechanisms underlying the adverse effects on bone remain unclear, the most important effect appears to be a rapid and substantial decrease in bone formation. This review will examine recent studies that quantify the risk of fracture with glucocorticoids, the mechanisms that underlie this increase in risk and the potential basis for differences in individual sensitivity. An important determinant of glucocorticoid sensitivity appears to be the presence of glucocorticoid-metabolizing enzymes within osteoblasts and this may enable improved estimates of risk and generate new approaches to the development of bone-sparing anti-inflammatory drugs.
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August 2004
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Review Article|
July 27 2004
Sensitivity of bone to glucocorticoids
Mark S. COOPER
1Division of Medical Sciences, University of Birmingham, Queen Elizabeth Hospital, Edgbaston, Birmingham B15 2TH, U.K.
Correspondence: Dr Mark S. Cooper (email M.S.Cooper@bham.ac.uk).
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Publisher: Portland Press Ltd
Received:
March 08 2004
Revision Received:
April 14 2004
Accepted:
April 28 2004
Accepted Manuscript online:
April 28 2004
Online ISSN: 1470-8736
Print ISSN: 0143-5221
The Biochemical Society
2004
Clin Sci (Lond) (2004) 107 (2): 111–123.
Article history
Received:
March 08 2004
Revision Received:
April 14 2004
Accepted:
April 28 2004
Accepted Manuscript online:
April 28 2004
Citation
Mark S. COOPER; Sensitivity of bone to glucocorticoids. Clin Sci (Lond) 1 August 2004; 107 (2): 111–123. doi: https://doi.org/10.1042/CS20040070
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