Service de rhumatologie, hôpital Cochin, 27, rue de Faubourg Saint-Jacques, 75014 Paris, France.
Service de rhumatologie, hôpital Cochin, 27, rue de Faubourg Saint-Jacques, 75014 Paris, France.
Joint Bone Spine. 2018 Oct;85(5):519-530. doi: 10.1016/j.jbspin.2018.02.009. Epub 2018 Apr 11.
To update the 2012 recommendations on pharmacotherapy for postmenopausal osteoporosis, under the aegis of the Bone Task Force of the French Society for Rheumatology (SFR) and of the Osteoporosis Research and Information Group (GRIO), in collaboration with scientific societies (Collège national des généralistes enseignants, Collège national des gynécologues et obstétriciens français, Fédération nationale des collèges de gynécologie médicale, Groupe d'étude de la ménopause et du vieillissement hormonal, Société française de chirurgie orthopédique, Société française d'endocrinologie, and Société française de gériatrie et de gérontologie).
Updated recommendations were developed by a task force whose members represented the medical specialties involved in the management of postmenopausal osteoporosis. The update was based on a literature review and developed using the method advocated by the French National Authority for Health (HAS).
The updated recommendations place strong emphasis on the treatment of women with severe fractures, in whom the use of osteoporosis medications is recommended. All the available osteoporosis medications are suitable in patients with severe fractures; zoledronic acid deserves preference as the fist-line drug after a hip fracture. In patients with or without non-severe fractures, the decision to use osteoporosis medications is based on bone mineral density values and in challenging cases, on probabilities supplied by prediction tools such as FRAX. All osteoporosis medications are suitable; raloxifene should be reserved for patients at low risk for peripheral fractures. The fracture risk should be reevaluated every 2 to 3 years to decide on the best follow-up treatment. These updated recommendations discuss the selection of first-line osteoporosis medications and treatment sequences.
在法国风湿病学会（SFR）的骨工作组以及骨质疏松症研究和信息组（GRIO）的主持下，更新 2012 年关于绝经后骨质疏松症药物治疗的建议，与科学协会合作（全国普通科医生学院、法国妇科和产科医生学院、全国妇科医生学院联合会、更年期和激素衰老研究小组、矫形外科法国学会、法国内分泌学会和法国老年学和老年病学会）。
更新的建议由一个工作组制定，其成员代表参与绝经后骨质疏松症管理的医学专业。更新是基于文献回顾，并使用法国国家卫生管理局（HAS）倡导的方法进行开发。
更新的建议非常重视严重骨折妇女的治疗，建议在这些患者中使用骨质疏松症药物。所有可用的骨质疏松症药物都适用于严重骨折患者；唑来膦酸作为髋部骨折后的一线药物应优先考虑。对于有或没有非严重骨折的患者，使用骨质疏松症药物的决定基于骨密度值，在具有挑战性的情况下，基于 FRAX 等预测工具提供的概率。所有骨质疏松症药物均适用；雷洛昔芬应保留给外周骨折风险低的患者。每 2 至 3 年重新评估骨折风险，以决定最佳随访治疗。这些更新的建议讨论了一线骨质疏松症药物的选择和治疗顺序。
