**11. Prophylaxis against side effects in prolonged corticosteroid**

Basic screening and prophylaxis of osteoporosis, ophthalmological evaluation, vitamin D and calcium supplementation during corticosteroid therapy, treatment with bisphosphonates (ie alendronate, risedronate) in patients at risk of developing osteoporosis (postmenopausal women and > 50 years and > 3 months on corticosteroid treatment), clinical systemic antifungals, antiviral and antibiotic therapy if needed, use of H2-blockers or proton pump inhibitors, antithrombotic prophylaxis in case of high thrombosis risk, psychological support if necessary, physiotherapy if long-term corticosteroid therapy is required [41].
