Woo T, Adachi J D
Best Pract Res Clin Rheumatol. 2001 Jul;15(3):469-81. doi: 10.1053/berh.2001.0161.
Bisphosphonates have been shown to increase bone mineral density in patients with established osteoporosis as well as those with osteopenia. The evidence conclusively shows a reduction in fracture rates in patients on the more potent nitrogen containing bisphosphonates. Indeed, significant vertebral fracture rate reduction has been demonstrated after only 1 year of therapy. Alendronate, a second-generation bisphosphonate, and risedronate, a third-generation bisphosphonate, are first line medications for the treatment of osteoporosis given their efficacy in preventing both vertebral and non-vertebral fractures. There is evidence that vertebral fractures may be prevented by intermittent cyclic therapy with etidronate. All three have been shown to increase bone mineral density in the spine, with alendronate and risedronate producing significant increases in hip bone density. Calcitonin has demonstrated the ability to reduce vertebral fracture rates with minimal changes in bone density. Calcitonin is also beneficial in reducing the bone pain associated with fractures.
双膦酸盐已被证明可增加已确诊骨质疏松症患者以及骨量减少患者的骨矿物质密度。证据确凿地表明，服用更强效的含氮双膦酸盐的患者骨折率降低。事实上，仅治疗1年后就已证明椎体骨折率显著降低。阿仑膦酸钠（一种第二代双膦酸盐）和利塞膦酸钠（一种第三代双膦酸盐）因其在预防椎体和非椎体骨折方面的疗效，是治疗骨质疏松症的一线药物。有证据表明，依替膦酸钠间歇循环治疗可预防椎体骨折。所有这三种药物都已被证明可增加脊柱的骨矿物质密度，阿仑膦酸钠和利塞膦酸钠可显著增加髋部骨密度。降钙素已证明有能力在骨密度变化最小的情况下降低椎体骨折率。降钙素在减轻与骨折相关的骨痛方面也有益处。
