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药物性骨折:筛查与治疗策略。

Medication-induced fractures: Screening and treatment strategies.

作者信息

Javed Laraib, Khakwani Aemen, Khan Uzair, Humphrey Mary Beth

机构信息

Department of Medicine, University of Oklahoma, College of Medicine, USA.

Department of Medicine, University of Oklahoma, College of Medicine, USA; Oklahoma City Veterans Affairs Medical Center, USA.

出版信息

Am J Med Sci. 2025 Jan;369(1):1-13. doi: 10.1016/j.amjms.2024.08.024. Epub 2024 Aug 28.

Abstract

Medication-induced osteoporosis leads to substantial fracture morbidity. With polypharmacy and the aging population in the United States, significant increases in medication-associated fractures are predicted. The most common medication to cause osteoporosis and increase fractures is glucocorticoids. Many other therapies, including loop diuretics, SGLT2 inhibitors, thiazolidinediones, proton pump inhibitors, selective serotonin reuptake inhibitors, heparin, warfarin, antiepileptics, aromatase inhibitors, anti-androgen therapies, gonadotropin-releasing hormone antagonists, and calcineurin inhibitors are associated with increased fracture risks. Here, we review the latest evidence for fracture risk for these medications and discuss fracture risk screening and management strategies.

摘要

药物性骨质疏松会导致严重的骨折发病率。在美国,随着联合用药和人口老龄化,预计与药物相关的骨折会大幅增加。导致骨质疏松和增加骨折风险最常见的药物是糖皮质激素。许多其他疗法,包括袢利尿剂、钠-葡萄糖协同转运蛋白2(SGLT2)抑制剂、噻唑烷二酮类、质子泵抑制剂、选择性5-羟色胺再摄取抑制剂、肝素、华法林、抗癫痫药、芳香化酶抑制剂、抗雄激素疗法、促性腺激素释放激素拮抗剂和钙调神经磷酸酶抑制剂,都与骨折风险增加有关。在此,我们综述了这些药物骨折风险的最新证据,并讨论骨折风险筛查和管理策略。

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