Oral Steroids Quickly Increase Your Risk of Fracture
WebMD News Archive
However, Johnston says the jury is still out on the need to prescribe
bisphosphonates for everyone taking steroids because "everybody doesn't get
The authors of the study, as well as Johnston and Manolagas, say the most
puzzling aspect of the new finding is the speed at which the fracture risk
increases. Manolagas tells WebMD that three months is too short a time for bone
mineral density to significantly decrease. In his editorial, he suggests that
the steroids may kill osteocytes, the most common type of bone cells. This cell
death, called apoptosis, may increase the fracture risk, he says.
Johnston says that Manolagas may be on the right track but he says he doubts
that the cell death theory can explain "the finding that fracture risk can
change so quickly." He says the answer may lie not in total bone mineral
density loss but "in where you lose it and the site at which it is
Just three month's
worth of oral steroids, which are commonly prescribed to patients with asthma
and disorders of the joints and bowels, increased chances of sustaining
fractures by 70%. The large European study shows these fractures can happen
much faster than experts have expected.
When the oral steroids
are stopped, the risk decreases at a similarly rapid rate.
treatment for osteoporosis should be included with oral steroid therapy, but
they don't agree when bone protection should begin, since not everyone gets
fractures. Doctors also are unsure of why the risk of fracture increases so