What is the main risk associated with long-term corticosteroid use?

Long-term corticosteroid use is primarily associated with osteoporosis, which is a significant risk due to the effects of corticosteroids on bone metabolism. Corticosteroids can inhibit the formation of new bone, decrease calcium absorption in the intestines, and increase renal excretion of calcium, all of which contribute to a decrease in bone density. This increased risk for osteoporosis stems from the fact that corticosteroids promote bone resorption while simultaneously suppressing bone formation, leading to a net loss of bone mass over time.

While other options present real concerns associated with long-term corticosteroid therapy, such as diabetes and hypertension, the most direct and widely recognized consequence in regards to skeletal health is osteoporosis. Providing patients with strategies to mitigate this risk, such as adequate vitamin D and calcium intake and possibly bisphosphonate therapy, becomes essential when long-term steroid therapy is necessary. It’s crucial for healthcare providers to monitor bone density in patients undergoing long-term corticosteroid treatment to help prevent fractures and maintain appropriate bone health.