Beware of your bones when on cortisone

Glucocorticoids are often prescribed to help patients with rheumatic illnesses, but using them long-term can come with serious side effects. — dpa

Long-term treatment with cortisone, e.g to cure rheumatic illnesses such as arthritis, can cause osteoporosis.

As a preventive measure, they should therefore be accompanied by a calcium-rich diet and the administration of vitamin D right from the start, according to the German Society for Rheumatology (DGRh).

It also makes sense to regularly check your bone density.

Doctors might consider prescribing drugs that inhibit bone loss or promote bone regeneration.

Glucocorticoids, colloquially known as cortisone, are used for rheumatic diseases and experts say the drugs are usually well tolerated when used for short periods.

This also holds for higher doses.

In the case of long-term treatments – meaning usage for at least three months or longer – side effects are not uncommon, e.g. a possible decrease in bone density, which can lead to osteoporosis.

In 30% to 40% of patients treated with cortisone over a period of about four and a half years, recent or older bone fractures could be detected, the DGRh estimates.

The problem is that many patients don’t notice the small bone fractures precisely because of the medicine they are taking, says DGRh expert Dr Jan Leipe.

Therefore, the bone problems are frequently overlooked and not treated.

As a result, the skeleton becomes more fragile, thus promoting further fractures.

“In the first three to six months of glucocorticoid therapy, bone density decreases by up to 12%,” he says.

After the end of treatment, the fracture risk declines again, as it is directly related to cortisone intake.

The DGRh therefore recommends as much cortisone as necessary, but also as little as possible, in combination with preventive measures against possible bone loss. – dpa