Department of Obstetrics and Gynaecology, University of Cape Town, South Africa.
S Afr Med J. 2012 Mar 8;102(5):285-8. doi: 10.7196/samj.5400.
The majority of women with fragility fractures have osteopenia rather than osteoporosis. In post hoc analyses of trials of alendronate and strontium ranelate, women with osteopenia had significant reductions in the incidence of fragility fractures and specific therapies may be mandated in women with osteopenia, as well as those with osteoporosis. Increasing numbers of fractures of the spine and hip occur in very elderly women and men over the age of 80, but in this age group it is often considered too late in life to start long-term specific therapies. In clinical trials of very elderly women, risendronate significantly reduced vertebral fractures and strontium ranelate significantly reduced vertebral, non-vertebral and symptomatic clinical fractures within 1 year of starting treatment. The indications for specific therapies for osteopenia and osteoporosis, as well as other measures for the prevention and treatment of fragility fractures, urgently need to be increased and widened.
大多数脆性骨折的女性患有骨量减少而非骨质疏松症。在阿伦膦酸盐和雷奈酸锶的试验的事后分析中，骨量减少的女性脆性骨折的发生率显著降低，可能需要对骨量减少的女性以及骨质疏松症的女性进行特定的治疗。在非常高龄的女性和 80 岁以上的男性中，脊柱和髋部骨折的数量不断增加，但在这个年龄段，人们通常认为开始长期特定治疗为时已晚。在对非常高龄女性的临床试验中，利塞膦酸钠显著降低了椎体骨折，雷奈酸锶在开始治疗 1 年内显著降低了椎体、非椎体和有症状的临床骨折。骨量减少和骨质疏松症的特定治疗适应证，以及预防和治疗脆性骨折的其他措施，迫切需要增加和扩大。
