Glucocorticoid-induced osteoporosis: An update on effects and management  Bjoern Buehring, MD, Ravi Viswanathan, MD, Neil Binkley, MD, William Busse, MD  Journal of Allergy and Clinical Immunology  Volume 132, Issue 5, Pages 1019-1030 (November 2013) DOI: 10.1016/j.jaci.2013.08.040 Copyright © 2013 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 1 Direct effects of glucocorticoids on bone cells. Shown are the adverse skeletal changes that result from an excess of glucocorticoids and lead to osteoporosis and osteonecrosis. The brown condensed cells are apoptotic osteoblasts and osteocytes. Apoptotic osteocytes disrupt the osteocyte-lacunar-canalicular network. Reproduced with permission from Weinstein.7 Journal of Allergy and Clinical Immunology 2013 132, 1019-1030DOI: (10.1016/j.jaci.2013.08.040) Copyright © 2013 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 2 Approach to premenopausal women and men aged less than 50 years initiating or receiving glucocorticoid therapy. pred, Prednisone. Reproduced with permission from Grossman et al.2 Journal of Allergy and Clinical Immunology 2013 132, 1019-1030DOI: (10.1016/j.jaci.2013.08.040) Copyright © 2013 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 3 Approach to postmenopausal women and men aged greater than 50 years initiating or receiving glucocorticoid therapy. *For low- and medium-risk patients, recommendations are for an anticipated or prevalent duration of 3 or more months of glucocorticoids. Reproduced with permission from Grossman et al.2 Journal of Allergy and Clinical Immunology 2013 132, 1019-1030DOI: (10.1016/j.jaci.2013.08.040) Copyright © 2013 American Academy of Allergy, Asthma & Immunology Terms and Conditions