Department of Internal Medicine, Division of Endocrinology, Riga East Clinical University Hospital, Riga, Latvia.
Ther Adv Musculoskelet Dis. 2013 Aug;5(4):182-98. doi: 10.1177/1759720X13485829.
Osteoporosis frequently remains underrecognized and undertreated in men. Most osteoporosis-related fractures could be prevented if men at risk would be diagnosed, treated, and remained compliant with therapy. Bisphosphonates, the mainstay of osteoporosis treatment, are potent antiresorptive agents that inhibit osteoclast activity, suppress in vivo markers of bone turnover, increase bone mineral density, decrease fractures, and likely improve survival in men with osteoporosis. The focus of the article is on intravenous zoledronic acid, which may be a preferable alternative to oral bisphosphonate therapy in patients with cognitive dysfunction, the inability to sit upright, polypharmacy, significant gastrointestinal pathology or suspected medication noncompliance. Zoledronic acid is approved in the United States (US) and European Union (EU) as an annual 5 mg intravenous infusion to treat osteoporosis in men. The zoledronic acid 4 mg intravenous dose has been studied in the prevention of bone loss associated with androgen deprivation therapy. This article reviews the evidence for zoledronic acid, currently the most potent bisphosphonate available for clinical use, and its therapeutic effects in the treatment of men with osteoporosis.
男性骨质疏松症常常未被识别和治疗。如果对有风险的男性进行诊断、治疗并坚持治疗，大多数与骨质疏松症相关的骨折是可以预防的。双膦酸盐是骨质疏松症治疗的主要药物，是一种有效的抗吸收剂，可抑制破骨细胞活性、抑制体内骨转换标志物、增加骨矿物质密度、减少骨折，并可能改善骨质疏松症男性的生存。本文的重点是静脉注射唑来膦酸，对于认知功能障碍、无法坐直、多种药物治疗、严重胃肠道疾病或疑似药物不依从的患者，静脉注射唑来膦酸可能是口服双膦酸盐治疗的更好选择。唑来膦酸在美国（美国）和欧盟（欧盟）被批准作为一种每年 5 毫克的静脉输注药物，用于治疗男性骨质疏松症。唑来膦酸 4 毫克的静脉剂量已被研究用于预防与雄激素剥夺治疗相关的骨质流失。本文综述了唑来膦酸的证据，目前它是临床应用中最有效的双膦酸盐，以及它在治疗男性骨质疏松症方面的治疗效果。
