高齢者の骨粗鬆症に対する薬物療法
Ian R Reid1, Emma O Billington2
1Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; Auckland District Health Board, Auckland, New Zealand.
Lancet (London, England)
|March 13, 2022
まとめ
骨粗鬆症の治療は,ビスホスフォネートやデノスマブなどの骨再吸収阻害剤,またはテリパラチドやロモゾズマブなどの骨形成性アナボリック剤を使用して骨折を予防することを目的としています. アナボリック薬はより有効ですが,抗吸収薬への移行が必要です.
科学分野:
- 内分泌学
- 薬理学について
- 整形外科
背景:
- 骨粗鬆症の治療は骨折の予防に焦点を当てています
- 薬剤は骨の再吸収を減らし,骨の形成を増加させることで骨折のリスクを軽減します.
- ビスフォスフォネートとデノスマブは一般的な抗吸収剤であり,テリパラチド,アボロパラチド,ロモゾズマブはアナボリック剤である.
研究 の 目的:
- 骨粗鬆症の管理のための現在の薬理学的戦略をレビューする.
- 反吸収剤とアナボリック剤の効能とメカニズムを比較する.
- アナボリック薬の作用の一時的な性質と,その後の抗吸収療法の必要性について議論する.
主な方法:
- 骨粗鬆症に対する薬剤のレビュー
- ビスフォスフォナート,デノスマブ,テリパラチド,アボロパラチド,ロモゾズマブの比較
- 骨折の減少率,骨密度の変化,治療期間に関する分析
主要な成果:
- ビスホスフォネートは骨折率を20~70%減少させ,長期使用は薬物休診が必要となる.
- デノスマブは類似した抗骨折効果を示しますが,治療中止後に骨折を起こす可能性があります.
- アナボリック薬は,抗吸収剤と比較して,骨折防止の効能と骨密度の向上を示していますが,その効果は一時的です.
結論:
- 抗吸収薬とアナボリック薬の両方が,骨粗鬆症の管理に有効です.
- アナボリック剤は,治療後の抗吸収薬への移行を必要とします.
- 骨粗鬆症の薬の最適なサイクリング戦略はまだ研究中です.
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