Cromer Barbara A, Scholes Delia, Berenson Abbey, Cundy Tim, Clark M Kathleen, Kaunitz Andrew M
CASE School of Medicine, Cleveland, Ohio, USA.
J Adolesc Health. 2006 Aug;39(2):296-301. doi: 10.1016/j.jadohealth.2006.03.011.
The purpose of this Position Paper is to review the published Black Box Warning regarding depot medroxyprogesterone acetate (DMPA) and bone loss as it relates to adolescent girls. The scientific findings that prompted the Food and Drug Administration to issue the warning are reviewed and the following additional issues are considered: (1) likely low risk of fracture related to DMPA use, (2) evidence of at least partial recovery after discontinuation of the method, and (3) the need to balance the physical, social and economic cost of adolescent pregnancy versus the immediate and long-term impact of DMPA on bone. A list of clinical guidelines is included, the main recommendation of which is to continue prescription of DMPA, with counseling about the risks and benefits, in most of the adolescent population desiring to use this contraceptive method.
本立场文件的目的是回顾已发布的关于醋酸甲羟孕酮长效注射剂（DMPA）与骨质流失的黑框警告，该警告与青春期女孩相关。文中回顾了促使美国食品药品监督管理局发布该警告的科学发现，并考虑了以下其他问题：（1）使用DMPA导致骨折的风险可能较低；（2）停用该方法后至少有部分恢复的证据；（3）需要权衡青少年怀孕的身体、社会和经济成本与DMPA对骨骼的近期和长期影响。文中还列出了临床指南，其主要建议是在大多数希望使用这种避孕方法的青少年人群中，继续开具DMPA处方，并就其风险和益处提供咨询。
