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Glucocorticoids: A review of its adverse effects including bone loss

Glucocorticoids (GCs) play a crucial role in the management of many inflammatory, immunological, and autoimmune diseases. Apart from symptomatic relief, they also act as disease-modifying agents as in arthritis and potent immunosuppressive agents as in vasculitides and systemic lupus erythematosus. However, they have been overused, misused, and abused because of their easy availability, low cost, and rapid action. On the other hand, they are also associated with a variety of adverse effects such as osteoporosis, increase risk of infections, cataract, glaucoma, myopathy, glucose intolerance, dyslipidemia, cardiovascular diseases, psychiatric disturbances, and adrenal suppression. GC-induced osteoporosis (GIOP) with increased fracture risk needs special mention, as it causes significant morbidity. In this review, we bring the readers up-to-date information with regard to the major adverse effects of systemic GCs with a special reference to prevention and management of GIOP.