Fluoride in the prevention and treatment of glucocorticoid-induced osteoporosis

Since the use of fluoride has been shown to stimulate bone formation and si nce decreased bone formation is a key feature in the pathogenesis of cortic osteroid-induced osteoporosis (CIOP), fluoride is, at least theoretically, attractive for the prevention and treatment of CIOP. In postmenopausal wome n positive effects of low-dose fluoride on the bone mineral density (BMD) o f the lumbar spine and on the vertebral fracture rate were found; in contra st, inpatients treated with high close fluoride, an increase in the periphe ral fracture rate was found. Randomized controlled trials of the effects of fluoride in Cs-treated patients are scarce. Although positive effects of l ow-dose fluoride on BMD of the lumbar spine have been observed fluoride doe s not represent the first choice therapy for the prevention or treatment of CIOP, because no positive effects on BMD of the hips and (so far) no reduc tion in the vertebral fracture rate have been shown.