Indian rheumatology association guidelines for management of glucocorticoid-induced osteoporosis Endorsed by: Endocrine Society of India and Indian Society for Bone & Mineral Research

Glucocorticoids have revolutionized the treatment ofinflammatory diseases in the past 60 years. The beneficialanti-inflammatory effects are associated with various side-effects. Osteoporosis resulting in fractures at spine and hipsis one of the significant adverse effects with long-term use.Other adverse effects include precipitation of diabetes,hypertension, cataract formation, skin thinning, osteonecro-sis and Cushingoid appearance. Around 1% of adult popu-lation chronically ingests glucocorticoids on long-termbasis and the percentage is higher in the elderly. In one ofthe largest studies having included more than 250,000 glu-cocorticoid users and same number of age matched controls,the incidence of hip and vertebral fractures was increased2–4 fold amongst patients taking daily doses of prednisolonemore than 2.5 mg.