University of Florence, Department of Surgery and Translational Medicine, Mineral and Bone Metabolic Diseases Unit, Largo Palagi, 1, 50100 Florence, Italy.
Expert Opin Investig Drugs. 2012 Aug;21(8):1169-76. doi: 10.1517/13543784.2012.696610. Epub 2012 Jun 14.
The biological process of fracture healing is complex with influences that are both patient-dependent and related to the trauma experienced and stability of the fracture. Fracture healing complications negatively affect the patient's quality of life, even more when fractures occur in the elderly osteoporotic patients.
In the polytherapy for bone regeneration, a high success rate was obtained with the use of growth factors, osteogenic cells, and osteoconductive factors. There have been high expectations that treatment with drugs active on bone remodeling would be efficient for acceleration of fracture healing. A literature search was undertaken using wording like "drug or pharmacology of fracture healing." This report will review the systemic pharmacological agents for which clinical trials documenting their efficacy on bone healing have been carried out or are underway.
At present the use of systemic pharmacological agents to enhance fracture healing in the clinical setting is still controversial. However, future clinical trials will offer the possibility to obtain data that will make possible the registration of a drug as a "healer."
骨折愈合的生物学过程较为复杂,既受患者自身因素的影响,也与所受创伤及骨折稳定性有关。骨折愈合并发症会降低患者的生活质量,而老年骨质疏松患者发生骨折时情况更为严重。
在骨再生的联合治疗中,使用生长因子、成骨细胞和骨传导因子可获得较高的成功率。人们曾高度期望作用于骨重塑的药物治疗能有效加速骨折愈合。本报告将对已开展或正在开展临床疗效评估的系统药理学药物进行综述。
目前,在临床环境中使用全身性药理药物来促进骨折愈合仍存在争议。然而,未来的临床试验将提供获取数据的可能性,这将使一种药物有可能被注册为“愈合剂”。