Treating osteoporosis

Richard Eastell MD
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Abstract

The aims of treatment of established osteoporosis are the alleviation of symptoms and reduction of the risk of further fractures. Currently available drugs are used to prevent further bone loss and can reduce the risk of further fractures by up to 50%. Drugs to increase bone mass inhibit bone resorption or stimulate bone formation. Most drugs approved for use in osteoporosis inhibit bone resorption, but some of these (e.g. hormone replacement therapy (HRT), bisphosphonates) increase BMD by 5–10% over the first 2 years of treatment. However, this contribution notes that drug treatments should be monitored by BMD, because some patients fail to respond to certain drugs. There is also evidence that the rate of bone loss is accelerated once treatment is stopped; it is therefore important to measure BMD or bone turnover markers after stopping treatment.

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治疗骨质疏松症
治疗骨质疏松症的目的是减轻症状和减少进一步骨折的风险。目前可用的药物用于防止进一步的骨质流失,并可将进一步骨折的风险降低高达50%。增加骨量的药物抑制骨吸收或刺激骨形成。大多数被批准用于治疗骨质疏松症的药物抑制骨吸收,但其中一些药物(如激素替代疗法(HRT)、双磷酸盐)在治疗的头两年可使骨密度增加5-10%。然而,这篇论文指出,药物治疗应该通过BMD进行监测,因为一些患者对某些药物没有反应。也有证据表明,一旦停止治疗,骨质流失的速度会加快;因此,在停止治疗后测量骨密度或骨转换指标是很重要的。
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