Uebelhart Brigitte, Rizzoli René
Service des maladies osseuses, Département de réhabilitation et gériatrie, HUG et Faculté de médecine de Genève, 1211 Genève 14.
Rev Med Suisse. 2010 Jan 13;6(231):56-60, 62.
Fracture risk could be evaluated with FRAX. Vitamin D administration decreases the rate of falls and deaths. Denosumab reduces the risk of fracture in postmenopausal women with osteoporosis and shows positive effects in case of breast and prostate cancers with hormone deprivation therapies. Zoledronate and teriparatide alone are more effective than risedronate and alendronate respectively in treatment of glucocorticoids induced osteoporosis. The association zoledronate and teriparatide may be promising. Vertebroplasty is not the first line treatment for symptomatic osteoporotic vertebral fractures. Osteonecrosis of the jaw and subtrochanteric femoral fractures are still events to consider in case of treatments with bisphosphonates.
骨折风险可用FRAX进行评估。补充维生素D可降低跌倒率和死亡率。地诺单抗可降低绝经后骨质疏松症女性的骨折风险，并且在乳腺癌和前列腺癌的激素剥夺治疗中显示出积极效果。唑来膦酸和特立帕肽在治疗糖皮质激素诱导的骨质疏松症方面分别比利塞膦酸盐和阿仑膦酸盐更有效。唑来膦酸和特立帕肽联合使用可能很有前景。椎体成形术并非症状性骨质疏松性椎体骨折的一线治疗方法。在使用双膦酸盐治疗时，颌骨坏死和股骨转子下骨折仍是需要考虑的情况。
