Osteoanabolic Agents for Osteoporosis.
Osteoanabolic Agents for Osteoporosis.
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DOI：
10.1210/js.2018-00118
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发表时间：
2018-08-01
影响因子：
4.1
通讯作者：
LeBoff MS
中科院分区：
文献类型：
--
作者：
Haas AV;LeBoff MS
治疗骨质疏松症的药物分为抗吸收药和合成代谢药。抗吸收药物阻止骨吸收，而合成代谢药物促进新骨形成。对于患有严重骨质疏松症、替代骨质疏松剂失效、对其他骨质疏松剂不耐受或禁忌症以及糖皮质激素引起的骨质疏松症的患者，应考虑服用合成代谢药物。目前已批准的合成代谢疗法有两种，Teriparatide和abaloparatide，第三种合成代谢药romozosumab正在接受美国食品和药物管理局(FDA)的审查。Teriparatide和abaloparatide作为每日皮下注射使用，已被证明能显著减少椎体和非椎体骨折。最常见的副作用是头痛和恶心，但Teriparatide和abaloparatide通常耐受性良好。合成代谢疗法的给药顺序很重要。在既往有抗吸收药物暴露的个体中，合成代谢药物的益处会减弱；然而，在合成代谢药物之后使用抗吸收药物会巩固骨密度的增加。骨质疏松症合成代谢疗法的临床应用及主要临床研究综述。
Medications for osteoporosis are classified as either antiresorptive or anabolic. Whereas antiresorptive agents prevent bone resorption, anabolic agents promote new bone formation. Anabolics should be considered in individuals with severe osteoporosis, failure of alternative osteoporosis agents, intolerability or contraindications to other osteoporosis agents, and glucocorticoid-induced osteoporosis. There are currently two approved anabolic therapies, teriparatide and abaloparatide, and a third anabolic agent, romozosumab, is under review by the US Food and Drug Administration. Teriparatide and abaloparatide are administered as daily subcutaneous injections and have been shown to reduce vertebral and nonvertebral fractures significantly. The most common side effects are headache and nausea, but teriparatide and abaloparatide are generally well tolerated. The sequence of administration of anabolic therapy is important. Benefits of anabolics are attenuated in individuals with prior antiresorptive exposure; however, antiresorptive agents administered after anabolics consolidate bone mineral density gains. Review of clinical use and major clinical studies of anabolic therapy for osteoporosis.