典型的な骨折は,長期にわたるビスフォスフォナート療法の潜在的な合併症である
1Johns Hopkins School of Medicine, 5200 Eastern Ave, Mason F. Lord Center Tower, Ste 4300, Baltimore, MD 21224, USA. dsellme1@jhmi.edu
JAMA
|October 7, 2010
まとめ
ビスホスフォナート療法は骨粗鬆症を効果的に治療しますが,長時間使用すると骨の修復が損なわれ,非典型的な骨折を引き起こす可能性があります. 管理には,リスク評価,治療中断,およびテリパラチドなどの代替案の検討が含まれます.
科学分野:
- 骨の生物学と薬理学について
- 整形外科の手術は,整形外科の手術です.
- 高齢者医療とは
背景:
- ビスホスフォネートは,低骨量および50歳以上の人の骨粗鬆症の治療に不可欠です.
- 現在のビスホスフォネートは,脊椎,非脊椎,股関節骨折を効果的に軽減します.
- 骨粗鬆症は,50歳以上の人の半数以上に影響します.
研究 の 目的:
- 長期にわたるビスホスフォナート療法に関連した非典型骨折の潜在的なリスクと管理をレビューする.
- これらの骨折の特徴と,これらの骨折の有病率と危険因子に関する限られたデータを強調する.
主な方法:
- 非典型骨折に関する症例報告と臨床シリーズのレビュー.
- ビスフォスフォナート関連骨折の現在の管理戦略の分析.
主要な成果:
- 長期にわたるビスホスフォナート療法は,骨の再建を抑制し,骨の修復機能の低下につながる可能性があります.
- 非典型的骨折は,の下部骨盤の関わり,前進性大腿痛,最小限のトラウマを含むユニークな特徴を有する.
- これらの骨折の罹患率と危険因子に関するデータは依然として限られている.
結論:
- 現在の管理には,骨折リスクの慎重な評価と適切なビスホスフォネート標的化が含まれています.
- 安定した患者では,5年間の治療後に12ヶ月の薬物休診を検討することが推奨されます.
- テリパラチドは,ビスホスフォナート療法中に非典型骨折を経験する患者のための治療選択肢である可能性があります.
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