医学
骨质疏松症
双膦酸盐
不利影响
加药
安慰剂
颌骨骨坏死
临床试验
重症监护医学
内科学
替代医学
病理
作者
Stuart L. Silverman,Michael Maricic
标识
DOI:10.1016/j.semarthrit.2006.12.003
摘要
To provide a review of current developments in bisphosphonates indicated for the treatment of several rheumatologic conditions, including postmenopausal and glucocorticoid-induced osteoporosis. This review summarizes the pathology, diagnosis, and treatment of both postmenopausal and glucocorticoid-induced osteoporosis and examines the results of current clinical trials of the newest oral and intravenous formulations of nitrogen-containing bisphosphonates. We discuss important adverse events, including upper gastrointestinal symptoms and osteonecrosis of the jaw. Additionally, we explore methods that may improve patient adherence to bisphosphonate therapy, which is currently suboptimal. Clinical studies have shown that oral bisphosphonates are efficacious in increasing bone mineral density and reducing risk of fracture. Despite concerns of upper gastrointestinal irritation, most of the newer oral bisphosphonates display a safety profile similar to placebo. Many of the newest formulations offer patients a choice in both dosing frequency and method of administration (either oral or intravenous). Nitrogen-containing bisphosphonates are important therapeutic options for the prevention and treatment of osteoporosis.
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