Secondary osteoporosis with consequent low-trauma fractures is the most frequent side effect of corticotherapy of inflammatory connective tissue diseases. Apart from glucocorticoids, particular inflammatory disease contributes to the pathogenesis of this progressive metabolic disorder. The authors discuss the mechanism of positive effect of vitamin D in prevention and therapy of glucocorticoid and inflammation induced osteoporosis. In this paper, effects of synthetic analogues of vitamin D and elementary vitamin D with respect to bone fracture risk are compared with other anti-osteoporotic agents. Newly discovered hormonal analogues affecting immune system, muscle function, and bone metabolism have increased the interest of vitamin D agents in prevention and treatment of glucocorticoid and inflammation induced osteoporosis. Synthetic analogues with suppressed hypercalcemic effect are currently being developed which might be used in high concentrations to increase their efficacy.

        Key words: glucocorticoids, osteoporosis, alphacalcidiol, vitamin D