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Erschienen in: rheuma plus 4/2016

01.11.2016 | Osteoporose

Individualisierte Therapie der Osteoporose

verfasst von: Dr. jur. Dr. med. B. Harbeck, H. Lehnert

Erschienen in: rheuma plus | Ausgabe 4/2016

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Zusammenfassung

Osteoporose ist eine systemische Skeletterkrankung, die insbesondere im höheren Lebensalter auftritt. In dieser Lebensphase stellt sie die häufigste Knochenerkrankung dar. Neue Medikamente haben das Therapiespektrum in den letzten Jahren erweitert, sodass eine personalisierte Therapie zunehmend in den Fokus rückt. Von entscheidender Bedeutung ist dabei eine Abwägung von Nutzen und Risiken der einzelnen Medikation, die den individuellen Gegebenheiten Rechnung trägt. Wichtige Gesichtspunkte sind die Osteoporoseform (primär/sekundär), bestehende Komorbiditäten, der Schweregrad der Erkrankung, Geschlecht, Alter und das Nebenwirkungsprofil der infrage kommenden Substanzen.
Literatur
1.
Zurück zum Zitat Abdelazim IA, Abdelrazak KM, Al-Kadi M, Yehia AH, Nusair BM, Faza MA (2014) Effect of raloxifene hydrochloride on bone mineral density and bone turnover in Kuwaiti postmenopausal women with osteoporosis. Arch Osteoporos 9:189CrossRefPubMed Abdelazim IA, Abdelrazak KM, Al-Kadi M, Yehia AH, Nusair BM, Faza MA (2014) Effect of raloxifene hydrochloride on bone mineral density and bone turnover in Kuwaiti postmenopausal women with osteoporosis. Arch Osteoporos 9:189CrossRefPubMed
2.
Zurück zum Zitat Amiche MA, Albaum JM, Tadrous M, Pechlivanoglou P, Lévesque LE, Adachi JD, Cadarette SM (2016) Efficacy of osteoporosis pharmacotherapies in preventing fracture among oral glucocorticoid users: a network meta-analysis. Osteoporos Int : (Epub ahead of print) Amiche MA, Albaum JM, Tadrous M, Pechlivanoglou P, Lévesque LE, Adachi JD, Cadarette SM (2016) Efficacy of osteoporosis pharmacotherapies in preventing fracture among oral glucocorticoid users: a network meta-analysis. Osteoporos Int : (Epub ahead of print)
3.
Zurück zum Zitat Beck TJ, Fuerst T, Gaither KW, Sutradhar S, Levine AB, Hines T, Yu CR, Williams R, Mirkin S, Chines AA (2015) The effects of bazedoxifene on bone structural strength evaluated by hip structure analysis. Bone 77:115–119CrossRefPubMed Beck TJ, Fuerst T, Gaither KW, Sutradhar S, Levine AB, Hines T, Yu CR, Williams R, Mirkin S, Chines AA (2015) The effects of bazedoxifene on bone structural strength evaluated by hip structure analysis. Bone 77:115–119CrossRefPubMed
4.
Zurück zum Zitat Black DM, Delmas PD, Eastell R, Reid IR, Boonen S, Cauley JA, Cosman F, Lakatos P, Leung PC, Man Z, Mautalen C, Mesenbrink P, Hu H, Caminis J, Tong K, Rosario-Jansen T, Krasnow J, Hue TF, Sellmeyer D, Eriksen EF, Cummings SR (2007) Once-yearly zoledronic acid for treatment of postmenopausal osteoporosis. N Engl J Med 356:1809–1822CrossRefPubMed Black DM, Delmas PD, Eastell R, Reid IR, Boonen S, Cauley JA, Cosman F, Lakatos P, Leung PC, Man Z, Mautalen C, Mesenbrink P, Hu H, Caminis J, Tong K, Rosario-Jansen T, Krasnow J, Hue TF, Sellmeyer D, Eriksen EF, Cummings SR (2007) Once-yearly zoledronic acid for treatment of postmenopausal osteoporosis. N Engl J Med 356:1809–1822CrossRefPubMed
5.
Zurück zum Zitat Black DM, Rosen CJ (2016) Clinical practice. Postmenopausal osteoporosis. N Engl J Med 374:254–262CrossRefPubMed Black DM, Rosen CJ (2016) Clinical practice. Postmenopausal osteoporosis. N Engl J Med 374:254–262CrossRefPubMed
6.
Zurück zum Zitat Chapurlat RD (2015) Odanacatib: a review of its potential in the management of osteoporosis in postmenopausal women. Ther Adv Musculoskelet Dis 7:103–109CrossRefPubMedPubMedCentral Chapurlat RD (2015) Odanacatib: a review of its potential in the management of osteoporosis in postmenopausal women. Ther Adv Musculoskelet Dis 7:103–109CrossRefPubMedPubMedCentral
7.
Zurück zum Zitat Chen LX, Zhou ZR, Li YL, Ning GZ, Zhang TS, Zhang D, Feng SQ (2015) Comparison of bone mineral density in lumbar spine and fracture rate among eight drugs in treatments of osteoporosis in men: A network meta-analysis. PLoS ONE 10:e0128032CrossRefPubMedPubMedCentral Chen LX, Zhou ZR, Li YL, Ning GZ, Zhang TS, Zhang D, Feng SQ (2015) Comparison of bone mineral density in lumbar spine and fracture rate among eight drugs in treatments of osteoporosis in men: A network meta-analysis. PLoS ONE 10:e0128032CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat Cianferotti L, D’Asta F, Brandi ML (2013) A review on strontium ranelate long-term antifracture efficacy in the treatment of postmenopausal osteoporosis. Ther Adv Musculoskelet Dis 5:127–139CrossRefPubMedPubMedCentral Cianferotti L, D’Asta F, Brandi ML (2013) A review on strontium ranelate long-term antifracture efficacy in the treatment of postmenopausal osteoporosis. Ther Adv Musculoskelet Dis 5:127–139CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat Collinge C, Favela J (2016) Use of teriparatide in osteporotic fracture patients. Injury 47(Suppl1):S36–S38CrossRefPubMed Collinge C, Favela J (2016) Use of teriparatide in osteporotic fracture patients. Injury 47(Suppl1):S36–S38CrossRefPubMed
10.
Zurück zum Zitat Cummings SR, San Martin J, McClung MR, Siris ES, Eastell R, Reid IR, Delmas P, Zoog HB, Austin M, Wang A, Kutilek S, Adami S, Zanchetta J, Libanati C, Siddhanti S, Christiansen C (2009) Denosumab for prevention of fractures in postmenopausal women with osteoporosis. N Engl J Med 361:756–765CrossRefPubMed Cummings SR, San Martin J, McClung MR, Siris ES, Eastell R, Reid IR, Delmas P, Zoog HB, Austin M, Wang A, Kutilek S, Adami S, Zanchetta J, Libanati C, Siddhanti S, Christiansen C (2009) Denosumab for prevention of fractures in postmenopausal women with osteoporosis. N Engl J Med 361:756–765CrossRefPubMed
11.
Zurück zum Zitat Dachverband Osteologie e. V. Prophylaxe, Diagnostik und Therapie der Osteoporose bei Männern ab dem 60. Lebensjahr und bei postmenopausalen Frauen (DVO- Leitlinie 2014.) Dachverband Osteologie e. V. Prophylaxe, Diagnostik und Therapie der Osteoporose bei Männern ab dem 60. Lebensjahr und bei postmenopausalen Frauen (DVO- Leitlinie 2014.)
12.
Zurück zum Zitat Ebina K, Hashimoto J, Kashii M, Hirao M, Kaneshiro S, Noguchi T, Tsukamoto Y, Yoshikawa H (2016) The effects of switching daily teriparatide to oral bisphosphonates or denosumab in patients with primary osteoporosis. J Bone Miner Metab : (Epub ahead of print) Ebina K, Hashimoto J, Kashii M, Hirao M, Kaneshiro S, Noguchi T, Tsukamoto Y, Yoshikawa H (2016) The effects of switching daily teriparatide to oral bisphosphonates or denosumab in patients with primary osteoporosis. J Bone Miner Metab : (Epub ahead of print)
13.
Zurück zum Zitat Eriksen EF, Diez-Pérez A, Boonen S (2014) Update on long-term treatment with bisphoshponates for postmenopausal osteoporosis: a systematic review. Bone 58:126–135CrossRefPubMed Eriksen EF, Diez-Pérez A, Boonen S (2014) Update on long-term treatment with bisphoshponates for postmenopausal osteoporosis: a systematic review. Bone 58:126–135CrossRefPubMed
14.
Zurück zum Zitat Ettinger B, Black DM, Mitlak BH, Knickerbocker RK, Nickelsen T, Genant HK, Christiansen C, Delmas PD, Zanchetta JR, Stakkestad J, Glüer CC, Krueger K, Cohen FJ, Eckert S, Ensrud KE, Avioli LV, Lips P, Cummings SR (1999) Reduction of vertebral fracture risk in postmenopausal women with osteoporosis treated with raloxifene: results from a 3‑year randomized clinical trial. Multiple Outcomes of Raloxifene Evaluation (MORE) Investigators. JAMA 282:637–645CrossRefPubMed Ettinger B, Black DM, Mitlak BH, Knickerbocker RK, Nickelsen T, Genant HK, Christiansen C, Delmas PD, Zanchetta JR, Stakkestad J, Glüer CC, Krueger K, Cohen FJ, Eckert S, Ensrud KE, Avioli LV, Lips P, Cummings SR (1999) Reduction of vertebral fracture risk in postmenopausal women with osteoporosis treated with raloxifene: results from a 3‑year randomized clinical trial. Multiple Outcomes of Raloxifene Evaluation (MORE) Investigators. JAMA 282:637–645CrossRefPubMed
15.
Zurück zum Zitat European Prospective Osteoporosis Study (EPOS) Group, Felsenberg D, Silman AJ, Lunt M, Armbrecht G, Ismail AA, Finn JD, Cockerill WC, Banzer D, Benevolenskaya LI, Bhalla A, Bruges-Armas J, Cannata JB, Cooper C, Dequeker J, Eastell R, Felsch B, Gowin W, Havelka S, Hoszowski K, Jajic I, Janott J, Johnell O, Kanis JA, Kragl G, Lopes-Vaz A, Lorenc R, Lyritis G, Masaryk P, Matthis C, Miazgowski T, Parisi G, Pols HA, Poor G, Raspe HH, Reid DM, Reisinger W, Schedit-Nave C, Stepan JJ, Todd CJ, Weber K, Woolf AD, Yershova OB, Reeve J, O’Neill TW (2002) Incidence of vertebral fracture in europe: results from the European Prospective Osteoporosis Study (EPOS). J Bone Miner Res 17:716–724CrossRef European Prospective Osteoporosis Study (EPOS) Group, Felsenberg D, Silman AJ, Lunt M, Armbrecht G, Ismail AA, Finn JD, Cockerill WC, Banzer D, Benevolenskaya LI, Bhalla A, Bruges-Armas J, Cannata JB, Cooper C, Dequeker J, Eastell R, Felsch B, Gowin W, Havelka S, Hoszowski K, Jajic I, Janott J, Johnell O, Kanis JA, Kragl G, Lopes-Vaz A, Lorenc R, Lyritis G, Masaryk P, Matthis C, Miazgowski T, Parisi G, Pols HA, Poor G, Raspe HH, Reid DM, Reisinger W, Schedit-Nave C, Stepan JJ, Todd CJ, Weber K, Woolf AD, Yershova OB, Reeve J, O’Neill TW (2002) Incidence of vertebral fracture in europe: results from the European Prospective Osteoporosis Study (EPOS). J Bone Miner Res 17:716–724CrossRef
17.
Zurück zum Zitat Greenspan SL, Perera S, Ferchak MA, Nace DA, Resnick NM (2015) Efficacy and safety of single-dose Zoledronic acid for osteoporosis in frail elderly women: A randomized clinical trial. JAMA 175:913–921 Greenspan SL, Perera S, Ferchak MA, Nace DA, Resnick NM (2015) Efficacy and safety of single-dose Zoledronic acid for osteoporosis in frail elderly women: A randomized clinical trial. JAMA 175:913–921
18.
Zurück zum Zitat Hadji P, Klein S, Gothe H, Häussler B, Kless T, Schmidt T, Steinle T, Verheyen F, Linder R (2013) Epidemiologie der Osteoporose-Bone Evaluation Study: Eine Analyse von Krankenkassen-Routinedaten. Dtsch Arztebl Int 110:52–57PubMedPubMedCentral Hadji P, Klein S, Gothe H, Häussler B, Kless T, Schmidt T, Steinle T, Verheyen F, Linder R (2013) Epidemiologie der Osteoporose-Bone Evaluation Study: Eine Analyse von Krankenkassen-Routinedaten. Dtsch Arztebl Int 110:52–57PubMedPubMedCentral
19.
Zurück zum Zitat Hegde V, Jo JE, Andreopoulou P, Lane JM (2015) Effect of osteoporosis medications on fracture healing. Osteoporos Int 27:861CrossRefPubMed Hegde V, Jo JE, Andreopoulou P, Lane JM (2015) Effect of osteoporosis medications on fracture healing. Osteoporos Int 27:861CrossRefPubMed
20.
Zurück zum Zitat Kanis JA on behalf of the World Health Organization Scientific Group (2007) Assessment of osteoporosis at the primary health-care level. Technical Report. World Health Organization Collaborating Centre for Metabolic Bone Diseases, University of Sheffield, UK. Printed by the University of Sheffield. World Health Organization: Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Technical Report Series 843, Geneva: WHO 1994 Kanis JA on behalf of the World Health Organization Scientific Group (2007) Assessment of osteoporosis at the primary health-care level. Technical Report. World Health Organization Collaborating Centre for Metabolic Bone Diseases, University of Sheffield, UK. Printed by the University of Sheffield. World Health Organization: Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Technical Report Series 843, Geneva: WHO 1994
21.
Zurück zum Zitat Kates SL, Ackert-Bicknell CL (2016) How do bisphosphonates affect fracture healing? Injury 47(Suppl 1):S65–S68CrossRefPubMed Kates SL, Ackert-Bicknell CL (2016) How do bisphosphonates affect fracture healing? Injury 47(Suppl 1):S65–S68CrossRefPubMed
22.
Zurück zum Zitat Liberman UA, Weiss SR, Broll J, Minne HW, Quan H, Bell NH, Rodriguez-Portales J, Downs RW Jr, Dequeker J, Favus M (1995) Effect of oral alendronate on bone mineral density and the incidence of fractures in postmenopausal osteoporosis. The Alendronate Phase III Osteoporosis Treatment Study Group. N Engl J Med 333:1437–1443CrossRefPubMed Liberman UA, Weiss SR, Broll J, Minne HW, Quan H, Bell NH, Rodriguez-Portales J, Downs RW Jr, Dequeker J, Favus M (1995) Effect of oral alendronate on bone mineral density and the incidence of fractures in postmenopausal osteoporosis. The Alendronate Phase III Osteoporosis Treatment Study Group. N Engl J Med 333:1437–1443CrossRefPubMed
23.
Zurück zum Zitat McClung MR, Grauer A, Boonen S, Bolognese MA, Brown JP, Diez-Perez A, Langdahl BL, Reginster JY, Zanchetta JR, Wasserman SM, Katz L, Maddox J, Yang YC, Libanati C, Bone HG (2014) Romosozumab in postmenopausal women with low bone mineral density. N Engl J Med 370:412–420 McClung MR, Grauer A, Boonen S, Bolognese MA, Brown JP, Diez-Perez A, Langdahl BL, Reginster JY, Zanchetta JR, Wasserman SM, Katz L, Maddox J, Yang YC, Libanati C, Bone HG (2014) Romosozumab in postmenopausal women with low bone mineral density. N Engl J Med 370:412–420
24.
Zurück zum Zitat Meunier PJ, Roux C, Ortolani S, Diaz-Curiel M, Compston J, Marquis P, Cormier C, Isaia G, Badurski J, Wark JD, Collette J, Reginster JY (2009) Effects of long-term strontium ranelate treatment on vertebral fracture risk in postmenopausal women with osteoporosis. Osteoporos Int 20:1663–1673CrossRefPubMedPubMedCentral Meunier PJ, Roux C, Ortolani S, Diaz-Curiel M, Compston J, Marquis P, Cormier C, Isaia G, Badurski J, Wark JD, Collette J, Reginster JY (2009) Effects of long-term strontium ranelate treatment on vertebral fracture risk in postmenopausal women with osteoporosis. Osteoporos Int 20:1663–1673CrossRefPubMedPubMedCentral
25.
Zurück zum Zitat Orwoll E, Teglbjaerg CS, Langdahl BL, Chapurlat R, Czerwinski E, Kendler DL, Reginster JY, Kivitz A, Lewiecki EM, Miller PD, Bolognese MA, McClung MR, Bone HG, Ljunggren Ö, Abrahamsen B, Gruntmanis U, Yang YC, Wagman RB, Siddhanti S, Grauer A, Hall JW, Boonen S (2012) A randomized, placebo-controlled study of the effects of denosumab for the treatment of men with low bone mineral density. J Clin Endocrinol Metab 97:3161–3169CrossRefPubMed Orwoll E, Teglbjaerg CS, Langdahl BL, Chapurlat R, Czerwinski E, Kendler DL, Reginster JY, Kivitz A, Lewiecki EM, Miller PD, Bolognese MA, McClung MR, Bone HG, Ljunggren Ö, Abrahamsen B, Gruntmanis U, Yang YC, Wagman RB, Siddhanti S, Grauer A, Hall JW, Boonen S (2012) A randomized, placebo-controlled study of the effects of denosumab for the treatment of men with low bone mineral density. J Clin Endocrinol Metab 97:3161–3169CrossRefPubMed
26.
Zurück zum Zitat Real J, Galindo G, Galván L, Lafarga MA, Rodrigo MD, Ortega M (2015) Use of oral bisphosphonates in primary prevention of fractures in postmenopausal women: a population-based cohort study. PLoS ONE 10:e0118178CrossRefPubMedPubMedCentral Real J, Galindo G, Galván L, Lafarga MA, Rodrigo MD, Ortega M (2015) Use of oral bisphosphonates in primary prevention of fractures in postmenopausal women: a population-based cohort study. PLoS ONE 10:e0118178CrossRefPubMedPubMedCentral
27.
Zurück zum Zitat Roux C, Hofbauer LC, Ho PR, Wark JD, Zillikens MC, Fahrleitner-Pammer A, Hawkins F, Micaelo M, Minisola S, Papaioannou N, Stone M, Ferreira I, Siddhanti S, Wagman RB, Brown JP (2014) Denosumab compared with risedronate in postmenopausal women suboptimally adherent to alendronate therapy: efficacy and safety results from a randomized open-label study. Bone 58:48–54CrossRefPubMed Roux C, Hofbauer LC, Ho PR, Wark JD, Zillikens MC, Fahrleitner-Pammer A, Hawkins F, Micaelo M, Minisola S, Papaioannou N, Stone M, Ferreira I, Siddhanti S, Wagman RB, Brown JP (2014) Denosumab compared with risedronate in postmenopausal women suboptimally adherent to alendronate therapy: efficacy and safety results from a randomized open-label study. Bone 58:48–54CrossRefPubMed
28.
Zurück zum Zitat Scheidt-Nave C, Banzer D, Abendroth K. Schlussbericht (1997) Multizentrische Studie zu Verteilung, Determination und prädiktivem Wert der Knochendichte in der deutschen Bevölkerung. Förderprojekt des Bundesministeriums für Forschung und Technologie. Förderkennzeichen 01KM 9304/0;1–45 Scheidt-Nave C, Banzer D, Abendroth K. Schlussbericht (1997) Multizentrische Studie zu Verteilung, Determination und prädiktivem Wert der Knochendichte in der deutschen Bevölkerung. Förderprojekt des Bundesministeriums für Forschung und Technologie. Förderkennzeichen 01KM 9304/0;1–45
29.
Zurück zum Zitat Senn C, Günther B, Popp AW, Perrelet R, Hans D, Lippuner K (2014) Comparative effects of teriparatide and ibandronate on spine bone mineral density (BMD) and microarchitecture (TBS) in postmenopausal women with osteoporosis: a 2‑year open-label study. Osteoporos Int 25:1945–1951CrossRefPubMed Senn C, Günther B, Popp AW, Perrelet R, Hans D, Lippuner K (2014) Comparative effects of teriparatide and ibandronate on spine bone mineral density (BMD) and microarchitecture (TBS) in postmenopausal women with osteoporosis: a 2‑year open-label study. Osteoporos Int 25:1945–1951CrossRefPubMed
30.
Zurück zum Zitat Watts NB, Diab DL (2010) Long-term use of bisphosphonates in osteoporosis. J Clin Endocrinol Metab 95:1555–1565CrossRefPubMed Watts NB, Diab DL (2010) Long-term use of bisphosphonates in osteoporosis. J Clin Endocrinol Metab 95:1555–1565CrossRefPubMed
31.
Zurück zum Zitat Zhang L, Pang Y, Shi Y, Xu M, Xu X, Zhang J, Ji L, Zhao D (2015) Indirect comparison of teriparatide, denosumab, and oral bisphosphonates for the prevention of vertebral and nonvertebral fractures in postmenopausal women with osteoporosis. Menopause 22:1021–1025CrossRefPubMed Zhang L, Pang Y, Shi Y, Xu M, Xu X, Zhang J, Ji L, Zhao D (2015) Indirect comparison of teriparatide, denosumab, and oral bisphosphonates for the prevention of vertebral and nonvertebral fractures in postmenopausal women with osteoporosis. Menopause 22:1021–1025CrossRefPubMed
32.
Zurück zum Zitat Harbeck B, Lehnert H (2015) Personalisierte Osteoporosetherapie. Dtsch Med Wochenschr 140:1672–1677CrossRefPubMed Harbeck B, Lehnert H (2015) Personalisierte Osteoporosetherapie. Dtsch Med Wochenschr 140:1672–1677CrossRefPubMed
Metadaten
Titel
Individualisierte Therapie der Osteoporose
verfasst von
Dr. jur. Dr. med. B. Harbeck
H. Lehnert
Publikationsdatum
01.11.2016
Verlag
Springer Vienna
Erschienen in
rheuma plus / Ausgabe 4/2016
Print ISSN: 1868-260X
Elektronische ISSN: 2191-2610
DOI
https://doi.org/10.1007/s12688-016-0089-8

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