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GIOP Start Timing — SCE Rheumatology MCQ

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EasyMetabolic Bone DiseaseGIOP Start TimingSCE Rheumatology

A 60-year-old woman on Prednisolone 15mg daily for PMR is not yet on bone protection. According to guidelines when should bone protection start?

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Correct answer: E — At the same time as starting glucocorticoids if treatment at ≥7.5mg equivalent is expected to continue for ≥3 months

NOGG/ACR GIOP: start bone protection simultaneously with glucocorticoids (not delayed). Threshold: ≥7.5mg Prednisolone expected ≥3 months. First-line: bisphosphonate plus calcium/vitamin D. Very high-risk: Teriparatide or Denosumab. DXA recommended but should not delay treatment.

Reference: NOGG 2021; ACR 2022 GIOP