Department of Medical and Surgical Sciences, University of Brescia, Montichiari, Italy.
Am J Med. 2010 Oct;123(10):877-84. doi: 10.1016/j.amjmed.2010.02.028.
Drug-induced osteoporosis is common and has a significant impact on the prognosis of patients suffering from chronic debilitating diseases. Glucocorticoids are the drugs causing osteoporotic fractures most frequently, but osteoporosis with fractures is observed also in women treated with aromatase inhibitors for breast cancer, in men receiving anti-androgen therapy for prostate cancer, in postmenopausal women treated with high doses of thyroxine, and in men and women treated with thiazolinediones for type 2 diabetes mellitus. Bone loss with fractures also occurs in patients treated with drugs targeting the immune system, such as calcineurin inhibitors, antiretroviral drugs, selective inhibitors of serotonin reuptake, anticonvulsants, loop diuretics, heparin, oral anticoagulants, and proton pump inhibitors.
药物性骨质疏松症较为常见，对患有慢性消耗性疾病患者的预后有重大影响。糖皮质激素是导致骨质疏松性骨折最常见的药物，但乳腺癌患者使用芳香化酶抑制剂、前列腺癌患者使用抗雄激素治疗、甲状腺素大剂量治疗的绝经后妇女、2 型糖尿病患者使用噻唑烷二酮类药物治疗时也会发生骨质疏松性骨折。靶向免疫系统的药物治疗也会导致骨丢失和骨折，如钙调神经磷酸酶抑制剂、抗逆转录病毒药物、5-羟色胺再摄取选择性抑制剂、抗惊厥药、袢利尿剂、肝素、口服抗凝剂和质子泵抑制剂。
