Lamy Olivier, Meier Christian, Everts-Graber Judith, Ferrari Serge
Service de médecine interne et Centre interdisciplinaire des maladies osseuses, Centre hospitalier universitaire vaudois, 1011 Lausanne.
Clinique d'endocrinologie, de diabète et de métabolisme, Hôpital universitaire de Bâle, 4031 Bâle.
Rev Med Suisse. 2025 Apr 16;21(914):783-787. doi: 10.53738/REVMED.2025.21.914.47112.
Osteoporosis is a chronic disease requiring lifelong treatment, both non-pharmacological and pharmacological. If life expectancy is long enough, drug treatment must be sequential and adapted to the risk of fracture and to comorbidities. With other treatments than bisphosphonates, sequences are mandatory. When denosumab is stopped, bisphosphonates reduce the rebound effect and limit the risk of vertebral fractures. Osteoanabolic treatments are used for 12 (romosozumab) to 24 months (teriparatide). Their anti-fracture benefits can be maintained with subsequent antiresorptive treatment (bisphosphonates, denosumab), which is an integral part of the management of patients pre-treated with an osteoanabolic agent. Regular monitoring is necessary to assess whether drug treatment should be interrupted, continued, or extended. The aim is to preserve bone health into old age and prevent fractures.
骨质疏松症是一种需要终身进行非药物和药物治疗的慢性疾病。如果预期寿命足够长，药物治疗必须是连续的，并要根据骨折风险和合并症进行调整。对于除双膦酸盐以外的其他治疗方法，治疗顺序是必不可少的。当停用狄诺塞麦时，双膦酸盐可降低反弹效应并限制椎体骨折的风险。骨合成代谢治疗使用12个月（罗莫佐单抗）至24个月（特立帕肽）。后续使用抗吸收治疗（双膦酸盐、狄诺塞麦）可维持其抗骨折益处，这是接受骨合成代谢药物预处理患者管理的一个组成部分。需要定期监测以评估药物治疗是否应中断、继续或延长。目的是在老年期保持骨骼健康并预防骨折。
