Yafteh

Background: Glucocorticoids are widely used in the treatment of inflammatory diseases. However, their use is associated with numerous side effects, the most significant of which is osteoporosis. Vertebral bones, the neck, the thigh, and particularly spongy bones are more commonly affected by glucocorticoids-induced osteoporosis than other types of bones.
Materials and Methods: To gather the necessary information, articles from the PubMed, Scopus, Web of Science, and Google Scholar databases were reviewed, and appropriate articles were selected as reference sources for this research.
Results: Glucocorticoids lead to osteoporosis by activating osteoclasts and inhibiting important signaling pathways, e.g., Wnt/β-catenin, PPAR-γ2, and BMP-2, which reduces osteoblastogenesis and increases the secretion of inhibitors such as sclerostin and Dkk-1. Drugs such as vitamin D, calcium, statins, bisphosphonates, denosumab, and romosuzumab prevent glucocorticoids-induced osteoporosis by counteracting these effects and stimulating bone density.
Conclusion: To prevent glucocorticoid-induced osteoporosis, especially in the elderly, it is advised to concurrently use vitamin D and calcium supplements, strontium ranelate, bisphosphonates, denosumab, and romosozumab alongside glucocorticoid medications.