Section of Endocrinology and Metabolism, Michigan Bone and Mineral Clinic, St. John Hospital and Medical Center, 22201 Moross Road, Detroit, MI 48236, USA.
Endocrinol Metab Clin North Am. 2012 Sep;41(3):655-61. doi: 10.1016/j.ecl.2012.05.003. Epub 2012 Jun 28.
Future directions in osteoporosis treatment will include development of medications with increasingly precise mechanistic targets, including the RANK-ligand pathway, cathepsin K inhibition, and Wnt signaling manipulation. More gains are likely with anabolics and newer antiresorptives that cause little or no suppression of formation. Optimal treatment of osteoporosis may require coordination of anabolic and antiresorptive treatment, following stimulation of bone formation with consolidation and long-term maintenance. Some well-established drugs may be useful in such regimens. We can also anticipate emphasis on cost containment using currently available drugs, especially as they become generic. Effective implementation and treatment continuity will be important themes.
骨质疏松症治疗的未来方向将包括开发具有越来越精确的机制靶点的药物，包括 RANK 配体途径、组织蛋白酶 K 抑制和 Wnt 信号转导的调节。使用几乎不抑制形成的合成代谢药物和新型抗吸收药物可能会取得更大的进展。骨质疏松症的最佳治疗可能需要协调合成代谢和抗吸收治疗，在骨形成刺激后进行巩固和长期维持。一些成熟的药物可能在这种方案中有用。我们还可以预期，随着现有药物（尤其是仿制药）的使用，将强调使用这些药物来控制成本。有效的实施和治疗连续性将是重要的主题。
