Miki Takami, Saito Shinichi
Geriatric Medicine, Postgraduate School of Medicine, Osaka City University Medical School.
Clin Calcium. 2006 Jan;16(1):167-74.
Raloxifene is preferred because of free from empty stomach and amelioration of lipid metabolism in spite of the significant effect of bisphosphonate on BMD and metabolic markers. As compliance is essential for the prevention of fracture, physicians should discuss about the treatment with their patients. There are no scientific evidences which drug is more suitable to osteoporotic patients. Therefore, bisphosphonate is recommended to the patients with severe osteoporosis, recognition of the disease, and/or expectation for the prevention of hip fracture by the treatment, on the condition that patients are not vitamin D deficiency. Raloxifene is recommended to the patients with mild osteoporosis, poor recognition of the disease, and/or low risk of the new fracture (s). The hyperlipidemic patients with osteoporosis are another candidates for raloxifene.
尽管双膦酸盐对骨密度和代谢指标有显著影响，但雷洛昔芬因其无需空腹服用且能改善脂质代谢而更受青睐。由于依从性对预防骨折至关重要，医生应与患者讨论治疗方案。目前尚无科学证据表明哪种药物更适合骨质疏松患者。因此，对于非维生素D缺乏的严重骨质疏松、已认识到疾病和/或期望通过治疗预防髋部骨折的患者，推荐使用双膦酸盐。对于轻度骨质疏松、对疾病认识不足和/或新发骨折风险较低的患者，推荐使用雷洛昔芬。患有骨质疏松的高脂血症患者是雷洛昔芬的另一类适用人群。
