Department of Life Sciences, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan.
Clin Interv Aging. 2013;8:681-8. doi: 10.2147/CIA.S37199. Epub 2013 Jun 7.
Osteoporosis is a skeletal disorder characterized by loss of bone mass, decreased bone strength, and an increased risk of bone fracture. The disease progresses with age, especially in postmenopausal women. Japan is one of the most rapidly aging societies worldwide. Japanese individuals over 65 years of age constituted 23.0% of the population in 2010 and 25.1% to 25.2% as of 2013. The estimated number of people with osteoporosis in Japan is currently 13 million. Bisphosphonates increase bone mineral density by inhibiting osteoclast-mediated bone resorption, thereby reducing the risk of fractures. Alendronate sodium hydrate (alendronate) is a bisphosphonate that potently inhibits bone resorption and is used to treat osteoporosis. Sufficient water is required to take an alendronate oral tablet; insufficient water could result in digestive system diseases, such as esophageal ulceration. Elderly patients with swallowing difficulty may choke on the tablet. Taking a tablet with oral jelly is a method to prevent digestive system disease and reduce the choking hazard. Once-weekly alendronate oral jelly was approved in 2012 by the Ministry of Health, Labour, and Welfare of Japan as the world's first drug for osteoporosis in a jelly formulation. It consists of a jelly portion and an air portion. The jelly formulation is smoothly discharged by pushing the air portion. Therefore, elderly patients with physical disabilities are able to easily take all of the jelly formulation from the package. In this review, this new formulation of alendronate sodium hydrate (oral jelly) is introduced and discussed in terms of osteoporosis treatment. This new formulation provides an alternative so that patients may select a method of dosing tailored to their preferences. Management of osteoporosis involves assessing fracture risk and preventing fractures. Higher adherence to the treatment of patients with osteoporosis and prevention of osteoporotic fractures are issues to be resolved.
骨质疏松症是一种骨骼疾病，其特征是骨量减少、骨强度降低以及骨折风险增加。该疾病随着年龄的增长而发展，尤其是在绝经后妇女中。日本是全球人口老龄化最快的国家之一。2010 年，65 岁以上的日本人占总人口的 23.0%，截至 2013 年，这一比例达到 25.1%至 25.2%。目前日本骨质疏松症患者人数估计为 1300 万。双膦酸盐通过抑制破骨细胞介导的骨吸收来增加骨矿物质密度，从而降低骨折风险。羟乙膦酸钠（阿仑膦酸钠）是一种强效的骨吸收抑制剂，用于治疗骨质疏松症。口服阿仑膦酸钠片需要充足的水；水不足可能导致消化系统疾病，如食管溃疡。有吞咽困难的老年患者可能会因药片而窒息。服用含口腔凝胶的片剂是预防消化系统疾病和降低窒息风险的一种方法。一周一次的阿仑膦酸钠口腔凝胶于 2012 年由日本厚生劳动省批准为世界上第一种以凝胶形式治疗骨质疏松症的药物。它由凝胶部分和空气部分组成。通过推动空气部分，凝胶制剂可以顺利排出。因此，身体残疾的老年患者能够轻松地从包装中取出所有的凝胶制剂。在这篇综述中，介绍并讨论了这种新的阿仑膦酸钠（口腔凝胶）制剂在骨质疏松症治疗中的应用。这种新的制剂为患者提供了一种替代方案，使他们可以选择适合自己喜好的给药方法。骨质疏松症的管理包括评估骨折风险和预防骨折。提高骨质疏松症患者对治疗的依从性和预防骨质疏松性骨折是需要解决的问题。
