| H01709 | |
| H number | H01709 |
| Name | Glucocorticoid-induced osteonecrosis |
| Description | Glucocorticoid-induced osteonecrosis is a common and severe adverse event. Glucocorticoid use is one of the most important causes of osteonecrosis. In patients receiving long-term therapy, glucocorticoids induce fractures in 30 to 50% and osteonecrosis in 9 to 40%. The pathogenesis of glucocorticoid-induced osteonecrosis is not fully understood but postulated mechanisms include hyperlipidemia, fat emboli and intravascular coagulation that reduce the supply of blood to the bones. Since not all patients who are treated with steroids develop osteonecrosis, the presence of additional risk factors or individual variation of glucocorticoids sensitivity has been suggested. The risks of this disease include advancing age, prolonged duration of treatment, increased daily dosage and cumulative dose, low body mass index, underlying disease, and polymorphisms in the glucocorticoid receptor. Bisphosphonates are first-line options for glucocorticoid-induced osteoporosis and may also be useful in glucocorticoid-induced osteonecrosis. It has been indicated that bisphosphonates may rapidly reduce pain, and delay joint collapse in patients with osteonecrosis. |
| Category | Musculoskeletal disease |
| Network | - |
| Gene | HSD11B2 (polymorphism) [HSA:3291] [KO:K00071] VEGF (polymorphism) [HSA:7422] [KO:K05448] COL2A1 (polymorphism) [HSA:1280] [KO:K19719] NR3C1 (polymorphism) [HSA:2908] [KO:K05771] SERPINE1 (polymorphism) [HSA:5054] [KO:K03982] ABCB1 (polymorphism) [HSA:5243] [KO:K05658] |
| Pathogen | - |
| Env factor | - |
| Carcinogen | - |
| Drug | Alendronate sodium [DR:D00939] Risedronate sodium [DR:D00942] Sodium risedronate hydrate [DR:D03234] Risedronate sodium monohydrate [DR:D11570] Zoledronic acid [DR:D01968] |
| Comment | See also H01529 Avascular necrosis of femoral head. |
| Other DBs | ICD-11: FB81.2 ICD-10: M87.1 MeSH: D005271 |
| Reference | PMID:21732837 AUTHORS Weinstein RS TITLE Clinical practice. Glucocorticoid-induced bone disease. JOURNAL N Engl J Med 365:62-70 (2011) DOI:10.1056/NEJMcp1012926 PMID:22169965 AUTHORS Weinstein RS TITLE Glucocorticoid-induced osteonecrosis. JOURNAL Endocrine 41:183-90 (2012) DOI:10.1007/s12020-011-9580-0 PMID:23357434 AUTHORS Gong LL, Fang LH, Wang HY, Peng JH, Si K, Zhu J, Han FF, Wang YH, Du GH, Pei LX, Liu LH TITLE Genetic risk factors for glucocorticoid-induced osteonecrosis: a meta-analysis. JOURNAL Steroids 78:401-8 (2013) DOI:10.1016/j.steroids.2013.01.004 PMID:22877431 AUTHORS Weinstein RS TITLE Glucocorticoid-induced osteoporosis and osteonecrosis. JOURNAL Endocrinol Metab Clin North Am 41:595-611 (2012) DOI:10.1016/j.ecl.2012.04.004 |