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Corticosteroid-induced osteoporosis prevention — GPhC CRA MCQ

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EasyEndocrine TherapeuticsCorticosteroid-induced osteoporosis preventionGPhC CRA

A patient on long-term prednisolone 15 mg daily for polymyalgia rheumatica attends the pharmacy. She asks if there is anything she should be taking to protect her bones. What is the most appropriate advice?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — She should take calcium and vitamin D supplementation, and her GP should consider a bisphosphonate for bone protection

Long-term corticosteroid use (equivalent to prednisolone 7.5 mg or more daily for three months or longer) significantly increases the risk of osteoporosis and fractures. NICE and the Royal Osteoporosis Society recommend calcium and vitamin D supplementation alongside consideration of a bisphosphonate (such as alendronic acid) for bone protection. A FRAX assessment may also be indicated to guide management. Dietary calcium alone is insufficient.

Reference: BNF; NICE CKS Corticosteroids; Royal Osteoporosis Society