Updated Guidelines Released for the Treatment of Glucocorticoid-Induced Osteoporosis

The American College of Rheumatology (ACR) published a summary of its updates to the Prevention and Treatment of Glucocorticoid-Induced Osteoporosis (GIOP) guidelines.

The previous ACR treatment guidelines were published in 2017. Since that time, new osteoporosis medications and literature have become available for clinicians, which warranted an update to the guidelines.

The updated prevention and treatment GIOP guidelines include: (1) Recommendations on the use of abaloparatide (PTHrP) and romosozumab, and (2) an understanding of sequential therapy. The 2 new medications have become available to use since the guidelines were published in 2017.

In the guidelines, the researchers stress the importance of patients understanding the need for additional therapy after discontinuing drugs taken to treat GIOP. The recommendation for sequential therapies is based on long-term follow-up studies and clinical trials. The guidelines also provide a course of action that clinicians can take when transitioning patients off certain medications—denosumab, teriparatide, abaloparatide, or romosozumab—with each GIOP medication having its own recommended treatment sequence.

Further, the guidelines still emphasize the importance of risk-stratifying patients as being low, moderate, or high risk of fracture while taking a glucocorticoid. A panel of adult and pediatric rheumatologists and endocrinologists provided a list of medications that are currently available for the prevention and treatment of osteoporosis, along with an update to the systemic literature review.

The final publication of the updated guidelines is anticipated in early 2023.


—Jessica Ganga


The American College of Rheumatology Board of Directors. 2022 American College of Rheumatology guideline for the prevention and treatment of glucocorticoid-induced osteoporosis (GIOP). September 14, 2022. Accessed October 4, 2022.