Department of Internal Medicine, Erasmus Medical Center, University Medical Center, Rotterdam, The Netherlands.
Department of Epidemiology, Erasmus Medical Center, University Medical Center, Rotterdam, The Netherlands.
Drugs. 2021 Nov;81(16):1831-1858. doi: 10.1007/s40265-021-01625-8. Epub 2021 Nov 1.
Osteoporosis is a highly prevalent bone disease affecting more than 37.5 million individuals in the European Union (EU) and the United States of America (USA). It is characterized by low bone mineral density (BMD), impaired bone quality, and loss of structural and biomechanical properties, resulting in reduced bone strength. An increase in morbidity and mortality is seen in patients with osteoporosis, caused by the approximately 3.5 million new osteoporotic fractures occurring every year in the EU. Currently, different medications are available for the treatment of osteoporosis, including anti-resorptive and osteoanabolic medications. Bisphosphonates, which belong to the anti-resorptive medications, are the standard treatment for osteoporosis based on their positive effects on bone, long-term experience, and low costs. However, not only medications used for the treatment of osteoporosis can affect bone: several other medications are suggested to have an effect on bone as well, especially on fracture risk and BMD. Knowledge about the positive and negative effects of different medications on both fracture risk and BMD is important, as it can contribute to an improvement in osteoporosis prevention and treatment in general, and, even more importantly, to the individual's health. In this review, we therefore discuss the effects of both osteoporotic and non-osteoporotic medications on fracture risk and BMD. In addition, we discuss the underlying mechanisms of action.
骨质疏松症是一种高发的骨骼疾病，影响着欧盟（EU）和美国（USA）超过 3750 万人。其特征是骨矿物质密度（BMD）低、骨质量受损以及结构和生物力学特性丧失，导致骨强度降低。骨质疏松症患者的发病率和死亡率增加，这是由于欧盟每年约有 350 万例新的骨质疏松性骨折所致。目前，有多种药物可用于治疗骨质疏松症，包括抗吸收和骨合成药物。双磷酸盐类药物属于抗吸收药物，因其对骨骼的积极作用、长期经验和低成本而成为骨质疏松症的标准治疗方法。然而，不仅用于治疗骨质疏松症的药物会影响骨骼：还有其他几种药物也被认为对骨骼有影响，特别是对骨折风险和 BMD 有影响。了解不同药物对骨折风险和 BMD 的积极和消极影响非常重要，因为它可以有助于改善整体骨质疏松症的预防和治疗，更重要的是，可以改善个体的健康。因此，在本次综述中，我们讨论了骨质疏松症和非骨质疏松症药物对骨折风险和 BMD 的影响。此外，我们还讨论了其潜在的作用机制。
