Post-steroid osteoporosis – epidemiology, pathophysiology, prevention and therapeutic proceeding

Post-steroid osteoporosis is one of the most common secondary osteoporosis observed. It is associated with multitude of clinical applications of glucocorticoids /GCS/ in number of chronic diseases of the locomotor system, hematology, transplantology, pneumology, where the therapeutic value of GCS is superior to the risk known from 1932 when Cushing first described their unfavourable influence on bone tissue. Importance of the disease that determines indication to use GCS repeatedly results in underestimating phenomenon of post-steroid osteoporosis until the moment of the first pathologic fracture, risk of which rises almost three times during chronic GCS therapy. Paper describes patomechanism of unfavourable direct and indirect influence of GCS on bone tissue, possibilities and strategy of therapeutic action in different groups of patients threatened with poststeroid osteoporosis, drugs used and potential trend of further investigations on prevention of poststeroid osteoporosis.