Borba Victória Z Cochenski, Mañas Nádila Cecyn Pietszkowski
Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brasil.
Arq Bras Endocrinol Metabol. 2010 Mar;54(2):213-9. doi: 10.1590/s0004-27302010000200018.
Anabolic drugs have recently widened therapeutic options in osteoporosis treatment, as they influence processes associated with bone formation to a greater extent and earlier than bone reabsortion. They positively affect a number of skeletal properties besides bone density, as intermittent administration of parathyroid hormone (PTH) results in an increase in the number and activity of osteoblasts leading to an increase in bone mass and improvement in skeletal architecture at both the trabecular and cortical bone. Human recombinant parathyroid hormone (hrPTH 1-84) and human recombinant PTH peptide 1-34 (teriparatide) belong to this group. The objective of this paper is to review PTH actions, benefits and adverse effects, action on biochemical markers, combination therapy with antiresorptive agents, impact of antiresorptive therapy prior to anabolic treatment, sequential treatment, and effect on glucocorticoid-induced osteoporosis.
合成代谢药物最近拓宽了骨质疏松症治疗的选择,因为它们比骨吸收过程在更大程度上且更早地影响与骨形成相关的过程。除了骨密度外,它们还对许多骨骼特性产生积极影响,因为间歇性给予甲状旁腺激素(PTH)会导致成骨细胞数量和活性增加,从而导致骨量增加以及小梁骨和皮质骨的骨骼结构改善。人重组甲状旁腺激素(hrPTH 1-84)和人重组PTH肽1-34(特立帕肽)属于这一类。本文的目的是综述PTH的作用、益处和不良反应、对生化标志物的作用、与抗吸收剂的联合治疗、合成代谢治疗前抗吸收治疗的影响、序贯治疗以及对糖皮质激素诱导的骨质疏松症的影响。