Neuere Erkenntnisse zur Pathogenese der Steroidosteoporose

Das Auftreten einer Osteoporose bei endogenem Hyperkortizismus wurde schon von Cushing beschrieben. Nach Einführung der Glukokortikoide in die Pharmakotherapie wurde sehr schnell offensichtlich, dass die Osteoporose eine der schwerwiegendsten Nebenwirkungen dieser Therapie ist. Die Glukokortikoid-induzierte-Osteoporose (GIOP) ist die dritthäufigste Osteoporoseform nach der postmenopausalen Osteoporose und der Altersosteoporose.

Wegen der multiplen zellulären Wirkorte der Glukokortikoide auf den Knochen ist die Pathophysiologie der Steroidosteoporose sehr komplex, und die experimentellen Befunde sind zum Teil kontrovers. Erhebliche Fortschritte im Verständnis des Knochenstoffwechsels werfen ein neues Licht auf die Wirkung von Glukokortikoiden am Knochen. In dieser Übersicht werden aktuell epidemiologische und experimentelle Untersuchungsergebnisse dargestellt, um daraus eine pathophysiologisch begründete Therapie herzuleiten. Schließlich soll auf mögliche neue therapeutische Entwicklungen in der Zukunft hingewiesen werden.

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