Cohen Stanley B
Radiant Research, 5939 Harry Hines Boulevard, Suite 400, Dallas, TX 75235, USA.
Curr Rheumatol Rep. 2004 Feb;6(1):59-65. doi: 10.1007/s11926-004-0084-2.
Over the past 15 years, bisphosphonates have been demonstrated as effective therapy for the treatment of osteoporosis based on their ability to suppress bone turnover resulting in increased bone mineral content and increased bone strength. The mechanism of action at the cellular level has been identified, and the more potent nitrogen-containing bisphosphonates clearly have reduced the risk of vertebral and nonvertebral fractures in patients with osteoporosis. Future use of these therapies is evolving to less frequent administration, and the interaction with anabolic therapies is presently being defined. Data to date support long-term safety with bisphosphonates in small numbers of patients treated for 5 to 10 years, and continued vigilant follow-up of the post-marketing experience will be necessary to determine if sustained bone turnover suppression is associated with rare musculoskeletal adverse events. Further development of bisphosphonates as adjunctive therapy to reduce bone metastases is in progress, and trials evaluating bisphosphonates as a structure modifying agent in osteoarthritis are nearing completion.
在过去15年中，双膦酸盐已被证明是治疗骨质疏松症的有效疗法，因为它们能够抑制骨转换，从而增加骨矿物质含量并增强骨强度。其在细胞水平的作用机制已被确定，更有效的含氮双膦酸盐明显降低了骨质疏松症患者发生椎体和非椎体骨折的风险。这些疗法未来的使用方式正朝着减少给药频率发展，目前正在明确其与促合成疗法的相互作用。迄今为止的数据支持双膦酸盐在少数接受5至10年治疗的患者中的长期安全性，有必要对上市后经验进行持续的密切随访，以确定持续抑制骨转换是否与罕见的肌肉骨骼不良事件相关。双膦酸盐作为减少骨转移的辅助疗法的进一步研发正在进行中，评估双膦酸盐作为骨关节炎结构改良剂的试验也即将完成。
