Drug Ther Bull. 2006 Apr;44(4):29-32.
In the UK, there are around 200,000 osteoporotic fractures each year. National guidelines in the UK recommend preventative treatment in patients who are at high risk of fracture on the basis of age, fracture history, bone mineral density and other risk factors. For secondary prevention, an oral bisphosphonate, such as alendronate or risedronate, is the drug of choice but may not be tolerated, particularly because of unwanted upper gastrointestinal effects. Raloxifene provides a potential oral alternative in women. National guidelines also suggest subcutaneous teriparatide for women aged more than 65 years with severe osteoporosis who have failed to tolerate or respond to a bisphosphonate; however, we believe use of this drug is problematic. Strontium ranelate (Protelos-Servier) is a new oral treatment for women with postmenopausal osteoporosis that is promoted as "the first dual action bone agent" and "the only drug to simultaneously increase bone formation and decrease bone resorption". Here we review the evidence for strontium ranelate and consider whether it has a role in postmenopausal osteoporosis.
在英国，每年约有20万例骨质疏松性骨折。英国的国家指南建议，根据年龄、骨折史、骨密度及其他风险因素，对骨折高危患者进行预防性治疗。对于二级预防，口服双膦酸盐类药物，如阿仑膦酸钠或利塞膦酸钠，是首选药物，但可能无法耐受，尤其是因为存在不良的上消化道副作用。雷洛昔芬为女性提供了一种潜在的口服替代药物。国家指南还建议，对于65岁以上患有严重骨质疏松且无法耐受双膦酸盐或对其无反应的女性，可皮下注射特立帕肽；然而，我们认为使用这种药物存在问题。雷奈酸锶（普罗力 - 赛诺菲）是一种用于治疗绝经后骨质疏松症女性的新型口服药物，被宣传为“首个具有双重作用的骨药”和“唯一能同时增加骨形成并减少骨吸收的药物”。在此，我们回顾雷奈酸锶的相关证据，并探讨其在绝经后骨质疏松症治疗中是否具有作用。
