Since this kind of osteoporosis is so difficult and so devastating, I am frequently asked about it, and many of my patients have this form of osteoporosis. I have been intending to write a more comprehensive page about this, with better evidence tables, but in the meantime will give a sketch about this disease.
Corticosteroids cause osteoporosis and fractures in a high percentage of patients.
There is a dose-dependent effect, which is difficult to define because of varying durations at each dose. The beneficial effects of steroids on the underlying disease may partially offset the detrimental effects on bone. Because the effects are so variable and can be clinically severe, patients embarking on long-term steroid treatment should have bone density monitored, and measures taken to try to preserve bone. Corticosteroids have several adverse effects on bone metabolism. The trabecular bone is affected more rapidly than the cortical bone.