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女性骨关节炎的药物治疗考虑因素和治疗选择。

Pharmacotherapeutic considerations and options for the management of osteoarthritis in women.

机构信息

University of Florida College of Medicine, Gainesville, FL, USA.

Department of Orthopaedic Surgery, Keck School of Medicine USC, Los Angeles, CA, USA.

出版信息

Expert Opin Pharmacother. 2020 Apr;21(5):557-566. doi: 10.1080/14656566.2020.1718649. Epub 2020 Jan 31.

Abstract

: Osteoarthritis is a chronic disease that leads to the destruction of articular cartilage and joints. As the most common joint disorder, osteoarthritis poses a great burden to the healthcare system. Most importantly, osteoarthritis is a heterogeneous disease characterized by a wide range of clinical features, phenotypes, and treatments. The burden of osteoarthritis is not equally distributed between men and women. Women have an increased risk of developing osteoarthritis, with worse symptoms, and poorer outcomes.: In this paper, the authors discuss pathophysiological considerations such as the wide spectrum of OA phenotypes. Women share many OA phenotypes with men including genetics, age, and trauma. Specific phenotypes from metabolic, anatomical, and hormonal influences vary greatly between the two sexes. This paper discusses the various current pharmacological treatment options for osteoarthritis including NSAIDs, Acetaminophen, Opioids, Duloxetine, SYSADOAs, monoclonal antibodies, intra-articular injections and hormonal therapy.: Further investigations of the pathophysiology of osteoarthritis are necessary to improve treatment options specific to women. As our understanding of the complex biology of osteoarthritis and the information surrounding it improves, newer and more effective treatments may decrease the suffering of osteoarthritis in a more efficient and less costly way.

摘要

骨关节炎是一种慢性疾病,可导致关节软骨和关节的破坏。作为最常见的关节疾病,骨关节炎给医疗保健系统带来了巨大负担。最重要的是,骨关节炎是一种异质性疾病,其特点是临床表现、表型和治疗方法广泛多样。骨关节炎的负担在男性和女性之间分布不均。女性患骨关节炎的风险增加,症状更严重,预后更差。

在本文中,作者讨论了病理生理学方面的考虑因素,例如广泛的 OA 表型谱。女性与男性共享许多 OA 表型,包括遗传、年龄和创伤。代谢、解剖和激素影响的特定表型在两性之间有很大差异。本文讨论了骨关节炎的各种当前药物治疗选择,包括 NSAIDs、醋氨酚、阿片类药物、度洛西汀、SYSADOAs、单克隆抗体、关节内注射和激素治疗。

需要进一步研究骨关节炎的病理生理学,以改善针对女性的治疗选择。随着我们对骨关节炎复杂生物学及其相关信息的理解不断提高,更新、更有效的治疗方法可能会以更有效和更经济的方式减少骨关节炎的痛苦。

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