Meier Christian, Uebelhart Brigitte, Aubry-Rozier Bérengère, Birkhäuser Martin, Bischoff-Ferrari Heike A, Frey Diana, Kressig Reto W, Lamy Olivier, Lippuner Kurt, Stute Petra, Suhm Norbert, Ferrari Serge
Division of Endocrinology, Diabetology and Metabolism, University Hospital and University of Basel, Switzerland.
Service of Bone Diseases, University Hospitals and Faculty of Medicine of Geneva, Switzerland.
Swiss Med Wkly. 2017 Aug 16;147:w14484. doi: 10.4414/smw.2017.14484. eCollection 2017.
Antiosteoporotic drugs are recommended in patients with fragility fractures and in patients considered to be at high fracture risk on the basis of clinical risk factors and/or low bone mineral density. As first-line treatment most patients are started with an antiresorptive treatment, i.e. drugs that inhibit osteoclast development and/or function (bisphosphonates, denosumab, oestrogens or selective oestrogen receptor modulators). In the balance between benefits and risks of antiresorptive treatment, uncertainties remain regarding the optimal treatment duration and the management of patients after drug discontinuation. Based on the available evidence, this position statement will focus on the long-term management of osteoporosis therapy, formulating decision criteria for clinical practice.
对于脆性骨折患者以及基于临床风险因素和/或低骨密度被认为骨折风险高的患者,推荐使用抗骨质疏松药物。作为一线治疗,大多数患者开始采用抗吸收治疗,即抑制破骨细胞发育和/或功能的药物(双膦酸盐、地诺单抗、雌激素或选择性雌激素受体调节剂)。在抗吸收治疗的获益与风险平衡中,关于最佳治疗持续时间以及停药后患者的管理仍存在不确定性。基于现有证据,本立场声明将聚焦于骨质疏松症治疗的长期管理,制定临床实践的决策标准。