{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T16:00:38Z","timestamp":1791907238912,"version":"4.3.4"},"reference-count":79,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2021,7,5]],"date-time":"2021-07-05T00:00:00Z","timestamp":1625443200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Worldwide, there are millions of people who have been diagnosed with osteoporosis, a bone disease that increases the risk of fracture due to low bone mineral density and deterioration of bone architecture. In the US alone, there are approximately ten million men and women diagnosed with osteoporosis and this number is still growing. Diagnosis is made by measuring bone mineral density. Medications used for the treatment of osteoporosis are bisphosphonates, denosumab, raloxifene, and teriparatide. Recently, romosozumab has been added as well. In recent years, a number of advances have been made in the field of diagnostic methods and the diverse treatment options for osteoporosis. Despite these advances and a growing incidence of osteoporosis, there is a large group being left undertreated or even untreated. This group of the under\/untreated has been called the treatment gap. Concerns regarding rare side effects of the medications, such as osteonecrosis of the jaw, have been reported to be one of the many causes for the treatment gap. Also, this group seems not to be sufficiently informed of the major benefits of the treatment and the diversity in treatment options. Knowledge of these could be very helpful in improving compliance and hopefully reducing the gap. In this paper, we summarize recent evidence regarding the efficacy of the various treatment options, potential side effects, and the overall benefit of treatment.<\/jats:p>","DOI":"10.3390\/jcm10133002","type":"journal-article","created":{"date-parts":[[2021,7,5]],"date-time":"2021-07-05T22:02:04Z","timestamp":1625522524000},"page":"3002","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":86,"title":["The Treatment Gap in Osteoporosis"],"prefix":"10.3390","volume":"10","author":[{"given":"Nazia","family":"Ayub","sequence":"first","affiliation":[{"name":"Division of Endocrinology and Diabetes, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malak","family":"Faraj","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Diabetes, Universit\u00e0 Campus Bio-Medico di Roma, 00128 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sam","family":"Ghatan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Erasmus University Medical Center, PO Box 2040-Na27-24, 3015 GD Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9532-2357","authenticated-orcid":false,"given":"Joannes A. A.","family":"Reijers","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Napoli","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Diabetes, Universit\u00e0 Campus Bio-Medico di Roma, 00128 Rome, Italy"},{"name":"Division of Bone and Mineral Diseases, Washington University, St. Louis, MO 63110, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Oei","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Erasmus University Medical Center, PO Box 2040-Na27-24, 3015 GD Rotterdam, The Netherlands"},{"name":"Department of Internal Medicine, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,7,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1016\/j.bonr.2016.07.005","article-title":"Hospitalizations for osteoporosis-related fractures: Economic costs and clinical outcomes","volume":"5","author":"Weycker","year":"2016","journal-title":"Bone Rep."},{"key":"ref_2","first-page":"1","article-title":"Fragility fractures in Europe: Burden, management and opportunities","volume":"15","author":"Karlsson","year":"2020","journal-title":"Arch. Osteoporos."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1016\/j.atherosclerosis.2016.06.039","article-title":"Bisphosphonates for cardiovascular risk reduction: A systematic review and meta-analysis","volume":"252","author":"Kranenburg","year":"2016","journal-title":"Atherosclerosis"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1947","DOI":"10.1359\/jbmr.2003.18.11.1947","article-title":"BMD at multiple sites and risk of fracture of multiple types: Long-term results from the Study of Osteoporotic Frac-tures","volume":"18","author":"Stone","year":"2003","journal-title":"J. Bone Miner. Res."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1007\/BF01623184","article-title":"Hip fractures in the elderly: A world-wide projection","volume":"2","author":"Cooper","year":"1992","journal-title":"Osteoporos. Int."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1002\/jbmr.3220","article-title":"Osteoporotic Vertebral Fracture Prevalence Varies Widely Between Qualitative and Quantitative Radiological Assessment Methods: The Rotterdam Study","volume":"33","author":"Oei","year":"2018","journal-title":"J. Bone Miner. Res."},{"key":"ref_7","first-page":"1010","article-title":"The prevalence of vertebral deformity in European men and women: The european vertebral osteoporosis study","volume":"11","author":"Felsenberg","year":"2009","journal-title":"J. Bone Miner. Res."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1016\/j.bone.2018.06.004","article-title":"Fracture incidence and secular trends between 1989 and 2013 in a population based cohort: The Rotterdam Study","volume":"114","author":"Trajanoska","year":"2018","journal-title":"Bone"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1016\/1043-2760(92)90032-V","article-title":"Epidemiology of osteoporosis","volume":"3","author":"Cooper","year":"1992","journal-title":"Trends Endocrinol. Metab."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1926","DOI":"10.1002\/jbmr.2301","article-title":"The Osteoporosis Treatment Gap","volume":"29","author":"Svedbom","year":"2014","journal-title":"J. Bone Miner. Res."},{"key":"ref_11","first-page":"9","article-title":"Primary osteoporosis in postmenopausal women","volume":"1","author":"Ji","year":"2015","journal-title":"Chronic Dis. Transl. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"436","DOI":"10.4158\/EP.12.4.436","article-title":"Secondary Osteoporosis: A Review of The Recent Evidence","volume":"12","author":"Painter","year":"2006","journal-title":"Endocr. Pract."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1056\/NEJMcp1513724","article-title":"Postmenopausal Osteoporosis","volume":"374","author":"Black","year":"2016","journal-title":"N. Engl. J. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"4118","DOI":"10.1210\/jcem.85.11.6953","article-title":"Fracture risk reduction with alendronate in women with osteoporosis: The Fracture Intervention Trial","volume":"85","author":"Black","year":"2000","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1097\/01.ogx.0000259157.48200.87","article-title":"Effects of Continuing or Stopping Alendronate After 5 Years of Treatment. The Fracture Intervention Trial Long-term Extension (FLEX): A Randomized Trial","volume":"62","author":"Black","year":"2007","journal-title":"Obstet. Gynecol. Surv."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1007\/s001980050010","article-title":"Randomized trial of the effects of risedronate on vertebral fractures in women with established postmenopausal osteo-porosis","volume":"11","author":"Reginster","year":"2000","journal-title":"Osteoporos. Int."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1809","DOI":"10.1056\/NEJMoa067312","article-title":"Once-Yearly Zoledronic Acid for Treatment of Postmenopausal Osteoporosis","volume":"356","author":"Black","year":"2007","journal-title":"N. Engl. J. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"756","DOI":"10.1056\/NEJMoa0809493","article-title":"Denosumab for Prevention of Fractures in Postmenopausal Women with Osteoporosis","volume":"361","author":"Cummings","year":"2009","journal-title":"N. Engl. J. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1016\/S2213-8587(17)30138-9","article-title":"10 years of denosumab treatment in postmenopausal women with osteoporosis: Results from the phase 3 randomised FREEDOM trial and open-label extension","volume":"5","author":"Bone","year":"2017","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1001\/jama.282.7.637","article-title":"Reduction of Vertebral Fracture Risk in Postmenopausal Women with Osteoporosis Treated with RaloxifeneResults From a 3-Year Randomized Clinical Trial","volume":"282","author":"Ettinger","year":"1999","journal-title":"JAMA"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1434","DOI":"10.1056\/NEJM200105103441904","article-title":"Effect of parathyroid hormone (1-34) on fractures and bone mineral density in postmenopausal women with osteoporo-sis","volume":"344","author":"Neer","year":"2001","journal-title":"N. Engl. J. Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1219","DOI":"10.1002\/jbmr.3427","article-title":"FRAME Study: The Foundation Effect of Building Bone with 1 Year of Romosozumab Leads to Continued Lower Fracture Risk After Transition to Denosumab","volume":"33","author":"Cosman","year":"2018","journal-title":"J. Bone Miner. Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2272","DOI":"10.1210\/jc.2012-1027","article-title":"Benefits and Risks of Bisphosphonate Therapy for Osteoporosis","volume":"97","author":"Khosla","year":"2012","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_24","first-page":"92","article-title":"Osteoporosis: A Review of Treatment Options","volume":"43","author":"Tu","year":"2018","journal-title":"J. Formul. Manag."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1007\/s00198-007-0540-8","article-title":"Mechanisms of action of bisphosphonates: Similarities and differences and their potential influence on clinical efficacy","volume":"19","author":"Russell","year":"2008","journal-title":"Osteoporos. Int."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1623","DOI":"10.1210\/jc.2019-00192","article-title":"Efficacy of Pharmacological Therapies for the Prevention of Fractures in Postmenopausal Women: A Network Meta-Analysis","volume":"104","author":"Barrionuevo","year":"2019","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1210\/er.2007-0014","article-title":"Receptor activator of nuclear factor kappaB ligand and osteoprotegerin regulation of bone remodeling in health and disease","volume":"29","author":"Kearns","year":"2008","journal-title":"Endocr. Rev."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1595","DOI":"10.1210\/jc.2019-00221","article-title":"Pharmacological Management of Osteoporosis in Postmenopausal Women: An Endocrine Society* Clinical Practice Guideline","volume":"104","author":"Eastell","year":"2019","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4158\/EP161435.GL","article-title":"American Association of Clinical Endocrinologists and American College of Endocrinology Clinical Practice Guidelines for the Diagnosis and Treatment of Postmenopausal Osteoporosis","volume":"22","author":"Camacho","year":"2016","journal-title":"Endocr. Pract."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e25","DOI":"10.15586\/jptcp.v27i1.655","article-title":"Romosozumab (sclerostin monoclonal antibody) for the treatment of osteoporosis in postmenopausal women: A review","volume":"27","author":"Shakeri","year":"2020","journal-title":"J. Popul. Ther. Clin. Pharmacol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1485","DOI":"10.1002\/jbmr.2888","article-title":"A Crisis in the Treatment of Osteoporosis","volume":"31","author":"Khosla","year":"2016","journal-title":"J. Bone Miner. Res."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1007\/s11657-013-0136-1","article-title":"Osteoporosis in the European Union: Medical management, epidemiology and economic Burden: A report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA)","volume":"8","author":"Hernlund","year":"2013","journal-title":"Arch. Osteoporos."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"2155","DOI":"10.1007\/s00198-019-05104-5","article-title":"Determinants, consequences and potential solutions to poor adherence to anti-osteoporosis treatment: Results of an expert group meeting organized by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) and the International Osteoporosis Foundation (IOF)","volume":"30","author":"Hiligsmann","year":"2019","journal-title":"Osteoporos. Int."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1929","DOI":"10.1002\/jbmr.2202","article-title":"Osteoporosis Medication Use After Hip Fracture in U.S. Patients Between 2002 and 2011","volume":"29","author":"Solomon","year":"2014","journal-title":"J. Bone Miner. Res."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1056\/NEJMoa022436","article-title":"The Effects of Strontium Ranelate on the Risk of Vertebral Fracture in Women with Postmenopausal Osteoporosis","volume":"350","author":"Meunier","year":"2004","journal-title":"N. Engl. J. Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1002\/jbmr.1998","article-title":"Atypical Subtrochanteric and Diaphyseal Femoral Fractures: Second Report of a Task Force of the American Society for Bone and Mineral Research","volume":"29","author":"Shane","year":"2014","journal-title":"J. Bone Miner. Res."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1002\/jbmr.2405","article-title":"Diagnosis and Management of Osteonecrosis of the Jaw: A Systematic Review and International Consensus","volume":"30","author":"Morrison","year":"2015","journal-title":"J. Bone Miner. Res."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1016\/j.joms.2009.03.050","article-title":"Prevalence of Osteonecrosis of the Jaw in Patients with Oral Bisphosphonate Exposure","volume":"68","author":"Lo","year":"2010","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"930","DOI":"10.1001\/archinternmed.2012.1796","article-title":"Increasing Occurrence of Atypical Femoral Fractures Associated with Bisphosphonate Use","volume":"172","author":"Meier","year":"2012","journal-title":"Arch. Intern. Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"2544","DOI":"10.1002\/jbmr.1719","article-title":"Incidence of atypical nontraumatic diaphyseal fractures of the femur","volume":"27","author":"Dell","year":"2012","journal-title":"J. Bone Miner. Res."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"100","DOI":"10.3109\/17453674.2015.1004149","article-title":"Risk of atypical femoral fracture during and after bisphosphonate use","volume":"86","author":"Schilcher","year":"2015","journal-title":"Acta Orthop."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1056\/NEJMoa1916525","article-title":"Atypical Femur Fracture Risk vs. Fragility Fracture Prevention with Bisphosphonates","volume":"383","author":"Black","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1016\/S1068-607X(98)00066-3","article-title":"Raloxifene effects on vasomotor and other climacteric symptoms in postmenopausal women","volume":"5","author":"Glusman","year":"1998","journal-title":"Prim. Care Updat. OB\/GYNS"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1827","DOI":"10.1016\/S0140-6736(13)60140-3","article-title":"Selective oestrogen receptor modulators in prevention of breast cancer: An updated meta-analysis of individual partici-pant data","volume":"381","author":"Cuzick","year":"2013","journal-title":"Lancet"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1080\/01926230490462138","article-title":"Bone Neoplasms in F344 Rats Given Teriparatide [rhPTH(1-34)] Are Dependent on Duration of Treatment and Dose","volume":"32","author":"Vahle","year":"2004","journal-title":"Toxicol. Pathol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"2429","DOI":"10.1002\/jbmr.1768","article-title":"The US postmarketing surveillance study of adult osteosarcoma and teriparatide: Study design and findings from the first 7 years","volume":"27","author":"Andrews","year":"2012","journal-title":"J. Bone Miner. Res."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"722","DOI":"10.1001\/jama.2016.11136","article-title":"Effect of Abaloparatide vs Placebo on New Vertebral Fractures in Postmenopausal Women with Osteoporosis: A Randomized Clinical Trial","volume":"316","author":"Miller","year":"2016","journal-title":"JAMA"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1343","DOI":"10.1161\/ATVBAHA.119.312371","article-title":"Cardiovascular Outcomes of Romosozumab and Protective Role of Alendronate","volume":"39","author":"Asadipooya","year":"2019","journal-title":"Arter. Thromb. Vasc. Biol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1016\/j.maturitas.2013.10.021","article-title":"The utility of absolute risk prediction using FRAX(R) and Garvan Fracture Risk Calculator in daily practice","volume":"77","author":"Eisman","year":"2014","journal-title":"Maturitas"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1146","DOI":"10.1002\/jbmr.2795","article-title":"Bone Mineral Density and Parathyroid Hormone as Independent Risk Factors for Mortality in Communi-ty-Dwelling Older Adults: A Population-Based Prospective Cohort Study in Brazil","volume":"31","author":"Domiciano","year":"2016","journal-title":"J. Bone Miner. Res."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1411","DOI":"10.1007\/s00198-010-1331-1","article-title":"Low bone mineral density is associated with increased mortality in elderly men: MrOS Sweden","volume":"22","author":"Johansson","year":"2010","journal-title":"Osteoporos. Int."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1007\/s00198-009-0970-6","article-title":"Low bone mineral density at femoral neck is a predictor of increased mortality in elderly Japanese women","volume":"21","author":"Suzuki","year":"2009","journal-title":"Osteoporos. Int."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.1359\/jbmr.070412","article-title":"Bone Loss, Weight Loss, and Weight Fluctuation Predict Mortality Risk in Elderly Men and Women","volume":"22","author":"Nguyen","year":"2007","journal-title":"J. Bone Miner. Res."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1974","DOI":"10.1359\/jbmr.2000.15.10.1974","article-title":"Rate of Bone Loss Is Associated with Mortality in Older Women: A Prospective Study","volume":"15","author":"Kado","year":"2000","journal-title":"J. Bone Miner. Res."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1016\/j.molmed.2009.07.001","article-title":"Vascular calcification and bone disease: The calcification paradox","volume":"15","author":"Persy","year":"2009","journal-title":"Trends Mol. Med."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1609","DOI":"10.1007\/s00198-018-4524-7","article-title":"The relation of low levels of bone mineral density with coronary artery calcium and mortality","volume":"29","author":"Ahmadi","year":"2018","journal-title":"Osteoporos. Int."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1016\/j.atherosclerosis.2015.02.013","article-title":"Bone health and coronary artery calcification: The Rotterdam Study","volume":"241","author":"Kavousi","year":"2015","journal-title":"Atherosclerosis"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1159\/000151769","article-title":"Bone Turnover, Osteopenia and Vascular Calcifications in Hemodialysis Patients","volume":"29","author":"Coen","year":"2009","journal-title":"Am. J. Nephrol."},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Kim, D.H., Rogers, J.R., Fulchino, L.A., Kim, C.A., Solomon, D.H., and Kim, S. (2015). Bisphosphonates and Risk of Cardiovascular Events: A Meta-Analysis. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0122646"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.atherosclerosis.2020.03.021","article-title":"Association between the cumulative exposure to bisphosphonates and hospitalization for atherosclerotic cardiovascular events: A population-based study","volume":"301","author":"Casula","year":"2020","journal-title":"Atherosclerosis"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1093\/qjmed\/93.2.105","article-title":"Use of oral corticosteroids in the United Kingdom","volume":"93","author":"Leufkens","year":"2000","journal-title":"QJM"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1002\/acr.21796","article-title":"Prevalence of oral glucocorticoid usage in the United States: A general population perspective","volume":"65","author":"Overman","year":"2013","journal-title":"Arthritis Rheum."},{"key":"ref_63","first-page":"5","article-title":"History of the development of corticosteroid therapy","volume":"29","author":"Benedek","year":"2011","journal-title":"Clin. Exp. Rheumatol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"750","DOI":"10.1001\/jama.1952.02930250032011","article-title":"Pathological fractures in patients with rheumatoid arthritis treated with cortisone","volume":"149","author":"DeMartini","year":"1952","journal-title":"JAMA"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1038\/jid.1952.86","article-title":"Osteoporosis and Pathological Fractures Following Treatment with Acth and Cortisone","volume":"19","author":"Teicher","year":"1952","journal-title":"J. Investig. Dermatol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1001\/jama.1954.02950050007002","article-title":"Vertebral fractures resulting from prolonged cortisone and corticotropin therapy","volume":"156","author":"Curtiss","year":"1954","journal-title":"J. Am. Med. Assoc."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1007\/s12020-018-1588-2","article-title":"Glucocorticoid-induced osteoporosis: An update","volume":"61","author":"Compston","year":"2018","journal-title":"Endocrine"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1038\/s41574-020-0341-0","article-title":"Pathogenesis of glucocorticoid-induced osteoporosis and options for treatment","volume":"16","author":"Chotiyarnwong","year":"2020","journal-title":"Nat. Rev. Endocrinol."},{"key":"ref_69","first-page":"CD001347","article-title":"Bisphosphonates for steroid-induced osteoporosis","volume":"2016","author":"Allen","year":"2016","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"1145","DOI":"10.1007\/s00198-019-04906-x","article-title":"Glucocorticoid-induced osteoporosis: 2019 concise clinical review","volume":"30","author":"Adami","year":"2019","journal-title":"Osteoporos. Int."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1136\/ard.54.1.66","article-title":"Steroid induced osteoporosis: An opportunity for prevention?","volume":"54","author":"Peat","year":"1995","journal-title":"Ann. Rheum. Dis."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1136\/pmj.78.918.242","article-title":"Osteoporosis prophylaxis during corticosteroid treatment: Failure to prescribe","volume":"78","author":"Hart","year":"2002","journal-title":"Postgrad. Med. J."},{"key":"ref_73","first-page":"413","article-title":"Suboptimal osteoporosis management: Moving beyond detection","volume":"31","author":"Neogi","year":"2004","journal-title":"J. Rheumatol."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1007\/s11657-017-0324-5","article-title":"UK clinical guideline for the prevention and treatment of osteoporosis","volume":"12","author":"Compston","year":"2017","journal-title":"Arch. Osteoporos."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"1521","DOI":"10.1002\/art.40137","article-title":"American College of Rheumatology Guideline for the Prevention and Treatment of Glucocorticoid-Induced Oste-oporosis","volume":"69","author":"Buckley","year":"2017","journal-title":"Arthritis Rheumatol."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"2257","DOI":"10.1007\/s00198-012-1958-1","article-title":"A framework for the development of guidelines for the management of glucocorticoid-induced osteoporosis","volume":"23","author":"Lekamwasam","year":"2012","journal-title":"Osteoporos. Int."},{"key":"ref_77","first-page":"550","article-title":"Multifaceted educational program increases prescribing of preventive medication for corticosteroid induced osteopo-rosis","volume":"31","author":"Naunton","year":"2004","journal-title":"J. Rheumatol."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.jocd.2018.03.009","article-title":"Prevention of Glucocorticoid-Induced Osteoporosis: Clinical audit to evaluate the implementation of National Osteoporosis Guideline Group 2017 guidelines in a primary care setting","volume":"22","author":"Carter","year":"2019","journal-title":"J. Clin. Densitom."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"1632","DOI":"10.1002\/jbmr.3164","article-title":"Screening for Atypical Femur Fractures Using Extended Femur Scans by DXA","volume":"32","author":"Smits","year":"2017","journal-title":"J. Bone Miner. 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