IMMUNOSUPPRESSIVE THERAPY AND THE SKELETON

Glucocorticoids and other immunosuppressive drugs, such as cyclosporin e A, are increasingly used today. One of the most common clinical situ ations in which they are prescribed is for immunosuppression after org an transplantation These drugs have diverse effects on the skeleton, h owever, and one of the most common sequelae of organ transplantation i s osteoporosis and fractures. Patients treated with immunosuppressive drugs should be carefully evaluated for osteoporosis, preferably prior to or at the time of initiation of immunosuppressive therapy. They sh ould be followed carefully with sequential bone-density measurements a nd biochemical indices of bone turnover Measures to prevent bone loss should be initiated early in the course of immunosuppressive therapy.