Garcés Carmen, García Luis-Emilio
Clinical Research Department, Lilly S.A., Avda. de la Industria 30, 28108 Alcobendas, Madrid, Spain.
Maturitas. 2006 Apr 20;54(1):47-54. doi: 10.1016/j.maturitas.2005.08.011. Epub 2005 Oct 27.
Combination therapy strategies for osteoporosis are reviewed in this article. Regimens including two antiresorptives agents increase BMD more than single therapy alone, but they have not proved to reduce fracture risk. The alternative of combining antiresorptives together with anabolics has gained more interest. There are, however, many questions still pending, as which antiresorptive should be used, and the appropriate sequence of the treatments. It seems that bisphosphonates can blunt the anabolic effect of parathyroid hormone (PTH) when given simultaneously. Instead, when PTH follows the antiresorptive treatment the anabolic effect seems not to be blunted. Finally, other possible approach would be to initiate therapy with an anabolic agent and maintain the effect with any antiresorptive if necessary.
本文综述了骨质疏松症的联合治疗策略。包含两种抗吸收药物的治疗方案比单一疗法能更大程度地提高骨密度，但尚未证实其能降低骨折风险。将抗吸收药物与促合成代谢药物联合使用的方法更受关注。然而，仍有许多问题悬而未决，比如应使用哪种抗吸收药物以及合适的治疗顺序。似乎双膦酸盐与甲状旁腺激素（PTH）同时给药时会减弱其促合成代谢作用。相反，若PTH在抗吸收治疗之后使用，其促合成代谢作用似乎不会减弱。最后，另一种可能的方法是以促合成代谢药物开始治疗，并在必要时用任何抗吸收药物维持疗效。
