Division of Rheumatology, Department of Internal Medicine, University of Michigan, Michigan, USA.
Curr Opin Rheumatol. 2023 May 1;35(3):161-169. doi: 10.1097/BOR.0000000000000934. Epub 2023 Mar 20.
This review seeks to summarize the literature relevant to the treatment of glucocorticoid-induced osteoporosis in premenopausal women; an issue commonly encountered by rheumatologists and yet lacking good clinical practice guidelines.
Although most of the relevant literature on osteoporosis includes postmenopausal women only, data from both randomized controlled trials and case reports suggest bisphosphonates can be an effective and well tolerated treatment for premenopausal patients. Data for other medications to treat premenopausal osteoporosis is less robust.
The use of bisphosphonates in young women may be safer than initially thought and should likely be used for the treatment of glucocorticoid-induced osteoporosis in rheumatology clinics. Further research is needed to continue to understand long-term risk.
本篇综述旨在总结绝经前女性糖皮质激素性骨质疏松症治疗相关文献;这是一个风湿科医生常遇见的问题,但目前缺乏良好的临床实践指南。
虽然大多数关于骨质疏松症的相关文献仅纳入绝经后女性,但随机对照试验和病例报告的数据均提示,双膦酸盐类药物治疗绝经前患者有效且耐受性良好。其他治疗绝经前骨质疏松症的药物的数据则不够充分。
在年轻女性中使用双膦酸盐类药物可能比最初认为的更安全,且在风湿科临床实践中治疗糖皮质激素性骨质疏松症时应考虑使用。需要进一步研究以持续了解长期风险。