Leuven University Centre for Metabolic Bone Diseases and Division of Geriatric Medicine, Leuven, Belgium.
Osteoporos Int. 2010 Jun;21 Suppl 2:S415-23. doi: 10.1007/s00198-010-1231-4. Epub 2010 May 13.
Osteoporotic fractures are associated with significant morbidity and mortality with an enormous impact on society and the lives of affected individuals. Age and menopause are the two main risk factors for osteoporosis, and women therefore need to be particularly concerned about bone loss at this time. In addition to suffering fracture-associated morbidity, women with prior fractures have an increased risk of future fractures. Young postmenopausal women who have experienced a fragility fracture therefore face a lifetime of fracture risk. The burden of fractures increases with advancing age, and bone mineral density declines, with women over the age of 80 years having the highest risk of fracture because of their high prevalence of osteoporosis and an increased likelihood of falls. A number of antiosteoporotic agents are available for the treatment of postmenopausal women including bisphosphonates, raloxifene, teriparatide, and strontium ranelate. For osteoporotic drugs to be beneficial in reducing the burden of fractures, they need to be effective against fracture in all age groups of postmenopausal women. With its dual mode of action, strontium ranelate is the first agent with proven early and sustained antifracture efficacy in all age groups including young postmenopausal women and those over 80 years. Evidence is now available to show that all women, including the elderly, can benefit from treatment to prevent further bone loss and restore lost bone to decrease the risk of further fractures. By implementing procedures to identify those at greatest risk and initiate safe and effective treatments, physicians can significantly improve patients' quality of life.
骨质疏松性骨折与较高的发病率和死亡率相关，对社会和患者的生活造成了巨大影响。年龄和绝经是骨质疏松症的两个主要危险因素，因此女性尤其需要关注此时的骨质流失。除了与骨折相关的发病率外，既往发生过骨折的女性发生未来骨折的风险增加。因此，经历脆性骨折的年轻绝经后女性面临着终生的骨折风险。随着年龄的增长，骨折负担增加，骨密度下降，80 岁以上的女性由于骨质疏松症的高发和跌倒的可能性增加，骨折风险最高。一些抗骨质疏松药物可用于治疗绝经后妇女，包括双磷酸盐类、雷洛昔芬、特立帕肽和雷奈酸锶。为了使抗骨质疏松药物能够降低骨折负担，它们需要对所有绝经后妇女年龄组的骨折都有效。雷奈酸锶具有双重作用机制，是首个在所有年龄组（包括年轻绝经后妇女和 80 岁以上妇女）均具有早期和持续抗骨折疗效的药物。现有证据表明，所有女性，包括老年人，都可以从治疗中获益，以防止进一步的骨质流失，恢复丢失的骨质，从而降低进一步骨折的风险。通过实施识别高风险人群并启动安全有效的治疗的程序，医生可以显著提高患者的生活质量。
