Dtsch Med Wochenschr 2015; 140(22): 1672-1677
DOI: 10.1055/s-0041-106054
Dossier
Vitamin D/Osteoporose
© Georg Thieme Verlag KG Stuttgart · New York

Personalisierte Osteoporosetherapie

Therapy of osteoporosis: towards personalized treatment?
Birgit Harbeck
1   Medizinische Klinik 1, UKSH Campus Lübeck
,
Hendrik Lehnert
2   Präsidium der Universität zu Lübeck
› Author Affiliations
Further Information

Publication History

Publication Date:
04 November 2015 (online)

Zusammenfassung

Osteoporose ist die häufigste Knochenerkrankung im höheren Lebensalter. Angesichts der stetigen Erweiterung des bestehenden Therapiespektrums kommt der Individualisierung der Therapie mit einer Abwägung von Nutzen und Risiken der einzelnen Medikation entscheidende Bedeutung zu. Bei der Auswahl des Präparats sind neben der Osteoporoseform (primär / sekundär), der Schweregrad der Erkrankung, Geschlecht, Alter, Nebenwirkungsprofil sowie vor allem auch bestehende Komorbiditäten zu berücksichtigen.

Abstract

Osteoporosis is the most common clinical disorder of bone metabolism. With regard to the growing spectrum of therapy options, treatment decisions should be made on an individual basis, taking into account the relative benefits and risks in different patient populations. Prioritization of drugs should be based on the form (primary / secondary) and severity of osteoporosis, sex, age, the specific contraindications and precautions of use of the various available medications and in particular, existing comorbidities.

 
  • Literatur

  • 1 Abdelazim IA, Abdelrazak KM, Al-Kadi M et al. Effect of raloxifene hydrochloride on bone mineral density and bone turnover in Kuwaiti postmenopausal women with osteoporosis. Arch Osteoporos 2014; 9: 189
  • 2 Beck TJ, Fuerst T, Gaither KW et al. The effects of bazedoxifene on bone structural strength evaluated by hip structure analysis. Bone 2015; 77: 115-119
  • 3 Black DM, Delmas PD, Eastell R et al. Once-yearly zoledronic acid for treatment of postmenopausal osteoporosis. N Engl J Med 2007; 356: 1809-1822
  • 4 Chen LX, Ning GZ, Zhou ZR et al. The Carcinogenicity of Alendronate in Patients with Osteoporosis: Evidence from Cohort Studies. PLoS One 2015; 10: e0123080
  • 5 Chen LX, Zhou ZR, Li YL et al. 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 2015; 10: e0128032
  • 6 Cianferotti L, DʼAsta F, Brandi ML. A review on strontium ranelate long-term antifracture efficady in the treatment of postmenopausal osteoporosis. Ther Adv Musculoskelet Dis 2013; 5: 127-139
  • 7 Cummings SR, San Martin J, McClung MR et al. Denosumab for prevention of fractures in postmenopausal women with osteoporosis. N Engl J Med 2009; 361: 756-765
  • 8 Dachverband Osteologie. Prophylaxe, Diagnostik und Therapie der Osteoporose bei Männern ab dem 60. Lebensjahr und bei postmenopausalen Frauen. 2014. http://www.dv-osteologie.org/dvo_leitlinien/osteoporose-leitlinie-2014 Letzter Zugriff am 23.07.15
  • 9 Eriksen EF, Diez-Pérez A, Boonen S. Update on long-term treatment with bisphoshponates for postmenopausal osteoporosis: a systematic review. Bone 2014; 58: 126-135
  • 10 Ettinger B, Black DM, Mitlak BH et al. 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 1999; 282: 637-645
  • 11 Greenspan SL, Perera S, Ferchak MA et al. Efficacy and Safety of Single-Dose Zoledronic Acid for Osteoporosis in Frail Elderly Women: A Randomized Clinical Trial. JAMA Intern Med 2015; 175: 913-921
  • 12 Hadji P, Klein S, Gothe H et al. Epidemiologie der Osteoporose- Bone Evaluation Study: Eine Analyse von Krankenkassen-Routinedaten. Dtsch Arztebl Int 2013; 110: 52-57
  • 13 Hochberg MC, Thompson DE, Black DM et al. Effect of alendronate on the age-specific incidence of symptomatic osteoporotic fractures. J Bone Miner Res 2005; 20: 971-976
  • 14 Liberman UA, Weiss SR, Broll J et al. 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 1995; 333: 1437-1443
  • 15 Lüttje D. Osteoporose im Alter. Dtsch Med Wochenschr 2015; 140: 473-476
  • 16 Meunier PJ, Roux C, Ortolani S et al. Effects of long-term strontium ranelate treatment on vertebral fracture risk in postmenopausal women with osteoporosis. Osteoporos Int 2009; 20: 1663-1673
  • 17 Miller PD, Derman RJ. What ist he best balance of benefits and risks among anti-resorptive therapies for postmenopausal osteoporosis?. Osteoporos Int 2010; 21: 1793-1802
  • 18 Niimi R, Kono T, Nishihara A et al. Analysis of daily teriparatide treatment for osteoporosis in men. Osteoporos Int 2015; 26: 1303-1309
  • 19 Orwoll E, Teglbjaerg CS, Langdahl BL et al. A randomized, placebo-controlled study of the effects of denosumab for the treatment of men with low bone mineral density. J Clin Endocrinol Metab 2012; 97: 3161-3169
  • 20 Real J, Galindo G, Galván L et al. Use of oral bisphosphonates in primary prevention of fractures in postmenopausal women: a population-based cohort study. PLoS One 2015; 10: e0118178
  • 21 Reginster JY, Neuprez A, Dardenne N et al. Efficacy and safety of currently marketed anti-osteoporosis medications. Best Pract Res Clin Endocrinol Metab 2014; 28: 809-834
  • 22 Reginster JY, Kaufman JM, Goemaere S et al. Maintenance of antifracture efficacy over 10 years with strontium ranelate in postmenopausal osteoporosis. Osteoporos Int 2012; 23: 1115-1122
  • 23 Roux C, Hofbauer LC, Ho PR et al. Denosumab compared with risedronate in postmenopausal women suboptimally adherent to alendronate therapy: efficacy and safety results from a randomized open-label study. Bone 2014; 58: 48-54
  • 24 Roux C, Briot K. How long should we treat?. Osteoporos Int 2014; 25: 1659-1666
  • 25 Senn C, Günther B, Popp AW et al. 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 2014; 25: 1945-1951
  • 26 Watts NB, Diab DL. Long-term use of bisphosphonates in osteoporosis. J Clin Endocrinol Metab 2010; 95: 1555-1565
  • 27 Zhang L, Pang Y, Shi Y et al. Indirect comparison of teriparatide, denosumab, and oral bisphosphonates for the prevention of vertebral and nonvertebral fractures in postmenopausal women with osteoporosis. Menopause 2015; 22: 1021-1025