骨质疏松症查以预防骨折:美国预防服务工作组的系统证据审查
Leila C Kahwati1,2, Christine E Kistler3, Graham Booth1,2
1RTI International-University of North Carolina at Chapel Hill Evidence-based Practice Center.
JAMA
|January 14, 2025
概括
在老年,高危女性的骨质疏松查减少部和重大骨折. 用双酸盐或代诺苏马布的药物治疗也降低了骨折风险,但没有显著的伤害.
科学领域:
- 老年学和预防医学
- 骨健康和骨质疏松症研究
背景情况:
- 脆弱性骨折会导致严重的病率和医疗费用.
- 有效的骨质疏松查策略对于早期发现和干预至关重要.
研究的目的:
- 为美国预防服务工作组审查骨质疏松症查有效性的证据.
- 评估风险评估工具的准确性和骨质疏松症药物治疗的有效性.
主要方法:
- 随机临床试验 (RCT) 的系统审查和元分析以及系统审查.
- 包括查,骨质疏松药物治疗和预测/诊断准确性的研究.
- 数据来源包括到2024年1月的PubMed,Embase,Cochrane图书馆和试验注册表.
主要成果:
- 在年龄较大,风险较高的女性中,关节骨折和主要骨质疏松性骨折的绝对风险降低很小.
- 评估了两阶段的查 (风险评估工具+骨质量).
- 与安慰剂相比,双酸盐和代诺苏马布显著降低了骨折的风险,但并没有显著增加不良事件.
结论:
- 65岁以上的高风险女性的查与骨折发生率的适度降低有关.
- 目前的证据不支持单独使用骨矿物质密度 (BMD) 或男性/年轻女性进行查.
- 在骨质疏松症患者中,药物治疗如双酸盐和德诺苏马布是有效的.
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