Pharmacological Therapy in Osteoporosis

Year 2012, Volume: 4 Issue: 1, 49 - 55, 01.04.2012

Nurdan Kotevoğlu Betül Toygar

Abstract

Osteoporosis is a disease resulting in an increased risk of skeletal fractures due to a reduction in the density of bone tissue. Treatment of osteoporosis typically involves the use of pharmacological agents in first place, exercise being the second arm. Bisphosphonates are often considered first-line therapy for osteoporosis due to clinical trials about data showing efficacy for global fracture risk reduction. Supplementation with calcium and vitamin D is recommended for all women aged 50 years and older to reduce the risk of falling, and hip fracture risk. Low-dose hormone therapy is appropriate for younger women who are experiencing other menopausal symptoms. In women for whom bisphosphonates are not appropriate or not tolerated or in younger postmenopausal women who have a low risk for hip fracture, SERMs are a suitable treatment option. Calcitonin is a good choice for patients who are unable or unwilling to tolerate other osteoporosis agents and have osteoporotic fracure pain. PTH reduces the risk of new vertebral fracture in severe osteoporosis. Denosumab will be among the new solutions in inhibition of bone resorption.

Keywords

Osteoporosis, therapy

Osteoporozda Tedavi Yaklaşımları

Abstract

Osteoporoz kemik dokusunun dansitesinde azalmayla kırık riskinde artışa neden olan bir hastalıktır. Tedavisi önplanda farmakolojik tedavi olmakla birlikte, egzersiz bir diğer kolu olarak düşünülmelidir.Bifosfanatlar kırık riskinde azalttıklarına dair çok sayıda klinik çalışma ile desteklenen birinci sırada yer alan ilaçlardır.Kalsiyum ve D vitamini replasman tedavisi 50 yaş ve üstündeki tüm kadınlara önerilir, düşme ve kalça kırığı riskini azaltır.Menapoz semptomları olan genç kadınlarda düşük doz hormon tedavisi düşünülebilir. Kalça kırığı riski olamayan genç bifosfanat tolere edemeyen postmenapozal kadınlarda SERM tercih edilebilir. Calcitonin diğere tedavilere uyum sağlayamayan ve özellikle kırıkta akut dönemde iyi seçenektir.Parathormon ağır osteoporozlarda özellikle yeni vertebra kırıklarının önlenmesinde etkindir. Denosumab yeni bir antirezorbtif olarak seçenekler arasında olacaktır.

Keywords

Osteoporoz, tedavi

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