The treatment gap: The missed opportunities for osteoporosis therapy
The treatment gap: The missed opportunities for osteoporosis therapy
复制标题
DOI：
10.1016/j.bone.2020.115833
复制
发表时间：
2021-03-01
期刊：
影响因子：
4.1
通讯作者：
Cooper, Cyrus
中科院分区：
文献类型：
--
作者：
Fuggle, Nicholas R.;Curtis, Beth;Cooper, Cyrus
尽管在过去三十年中，骨质疏松症的流行病学、病理生理学、风险评估和治疗方面的研究取得了重大进展，但仍有相当比例的高骨折风险男性和女性未得到治疗，即所谓的“治疗缺口”。这篇综述总结了造成这种治疗差距的患者、医生和政策相关的重要原因，然后更详细地讨论：(a)双膦酸盐治疗骨质疏松症疗效的证据基础；(b)有关这一广泛使用的治疗类别的不良反应的最新证据，最明显的是非典型股骨骨折和颌骨骨坏死；(c)改善管理这种疾病的二级和一级预防途径的现有战略。
Despite substantial advances in delineation of the epidemiology, pathophysiology, risk assessment and treatment of osteoporosis over the last three decades, a substantial proportion of men and women at high risk of fracture remain untreated the so-called "treatment gap". This review summarises the important patient-, physicianand policyrelated causes of this treatment gap, before discussing in greater detail: (a) the evidence base for the efficacy of bisphosphonates in osteoporosis; (b) recent evidence relating to the adverse effects of this widely used therapeutic class, most notably atypical femoral fracture and osteonecrosis of the jaw; (c) available strategies to improve both secondary and primary prevention pathways for the management of this disorder.