Figure 1.

 The degree of bone loss due to corticosteroids varies according to dose, underlying disease and, possibly, genetic factors. The case for intervention is strong (primary prevention) in postmenopausal women but is less clear in premenopausal women. As fracture risk is a function of time receiving corticosteroids, it is appropriate to consider secondary prevention in pre- and postmenopausal women receiving long term CS who have low BMD. Reproduced with permission from Sambrook PN, Corticosteroid osteoporosis: practical implications of recent trials. J Bone Min Res 2000;15:1645–9.