Division of Rheumatology and Department of Medicine, St Joseph's Healthcare and McMaster University, Hamilton, Ontario, Canada.
Ther Clin Risk Manag. 2010 Oct 21;6:497-503. doi: 10.2147/TCRM.S7776.
Glucocorticoids are commonly used in various fields within medicine. One of their most common and clinically significant side effects is glucocorticoid-induced osteoporosis (GIOP). GIOP is a disease leading to progressive decreases in bone mineral density, decreased bone strength, and increased risk of skeletal fractures. GIOP has a significant impact on the morbidity and health-related quality of life of the patients it affects. Glucocorticoids have deleterious effects on bone through promoting osteoblast apoptosis and inhibiting osteoblastogenesis. Teriparatide exerts anabolic effects on bone, so it is understandable why teriparatide is thought to be a rational treatment option. Clinical studies have indicated teriparatide is efficacious in the treatment of GIOP to improve bone mineral density values at the lumbar spine and femoral neck. Some evidence also suggests teriparatide may reduce rates of vertebral fractures in GIOP patients. Overall, this review of the current clinical evidence suggests teriparatide may be an efficacious and promising agent in the treatment of GIOP.
糖皮质激素在医学的各个领域中被广泛应用。其最常见且具有重要临床意义的副作用之一是糖皮质激素诱导的骨质疏松症(GIOP)。GIOP 是一种导致骨矿物质密度逐渐下降、骨强度降低和骨折风险增加的疾病。GIOP 对其所影响的患者的发病率和健康相关生活质量有重大影响。糖皮质激素通过促进成骨细胞凋亡和抑制成骨细胞生成对骨骼产生有害影响。特立帕肽对骨骼具有合成代谢作用,因此可以理解为什么特立帕肽被认为是一种合理的治疗选择。临床研究表明,特立帕肽可有效治疗 GIOP,可改善腰椎和股骨颈的骨矿物质密度值。一些证据还表明,特立帕肽可能降低 GIOP 患者的椎体骨折发生率。总的来说,对当前临床证据的回顾表明,特立帕肽可能是治疗 GIOP 的一种有效且有前途的药物。