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[除糖皮质激素外其他药物相关的骨折风险]

[Fracture risk associated with drugs other than glucocorticoids].

作者信息

Okazaki Ryo

机构信息

Third Department of Medicine, Teikyo University Chiba Medical Center, Japan.

出版信息

Clin Calcium. 2014 Mar;24(3):357-65.

Abstract

Many drugs influence fracture risk besides glucocorticoid, a most common cause of drug-induced osteoporosis. It is well established that drugs used for anti-sex steroids therapy for breast and prostate cancers increase fracture risk, including GnRH agonists, aromatase inhibitors, and anti-androgens. Increased fracture risk is also established with anti-diabetic thiazolidinediones by a randomized control study as well as meta analysis of observational studies. Multiple observational studies have indicated increased fracture risks with selective serotonin reuptake inhibitors and proton pump inhibitors. Excess thyroid hormones, anti epileptics, heparin, warfarin, may also be associated with an increase in fracture risks. On the contrary, statins, thiazides, beta blockers, and nitrates may be associated with decreased fracture risks.

摘要

除糖皮质激素(药物性骨质疏松最常见的病因)外,许多药物也会影响骨折风险。众所周知,用于乳腺癌和前列腺癌抗性激素治疗的药物会增加骨折风险,包括促性腺激素释放激素激动剂、芳香化酶抑制剂和抗雄激素药物。一项随机对照研究以及观察性研究的荟萃分析表明,抗糖尿病药物噻唑烷二酮类也会增加骨折风险。多项观察性研究表明,选择性5-羟色胺再摄取抑制剂和质子泵抑制剂会增加骨折风险。甲状腺激素过量、抗癫痫药、肝素、华法林也可能与骨折风险增加有关。相反,他汀类药物、噻嗪类药物、β受体阻滞剂和硝酸盐类药物可能与骨折风险降低有关。

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