骨質疏鬆症的藥物治療

Pharmacotherapy of Osteoporosis

吳俊男(Chun-Nan Wu) ； 蕭鈞百(Chun-Pai Hsiao)

《南臺灣醫學雜誌》 9卷1期 (2013/06) Pp. 6-14

https://doi.org/10.6726/MJST.201306_9(1).0002

摘要

隨著人類壽命的延長，骨質疏鬆症已是全球僅次於心血管疾病的第二大重要流行病。長久以來對老年人生活品質的威脅已為公認的事實，而近年來生活型態的改變，更使此疾病受到重視。此疾病主要致病原因為骨骼形成與骨骼溶蝕不平衡所導致骨骼脆弱及容易骨折之骨骼疾病，好發族群有停經後婦女、65歲以上之男性及次發性骨質疏鬆症等。這些族群建議定期檢測骨質密度，以評斷骨質流失的狀況，適時給予治療。目前防治骨質疏鬆及骨折的藥物，依其作用機轉，可分為抗破骨或抗流失類藥物（包括雙磷酸鹽、抑鈣激素、選擇性雌激素受體調節劑、性激素類、破骨細胞酵素抑制劑、RANKL單株抗體等）；促造骨或促骨生成類藥物（以副甲腺素及其活性片段為主），以及混合型（目前只有鍶鹽一種）三類。然而在使用任何藥物的同時，每日仍需補充維生素D及鈣，並維持良好之生活習慣，適量運動，避免抽煙，預防跌倒，才能預防及治療骨質疏鬆症。

關鍵字

骨質疏鬆症 ； 雙磷酸鹽類 ； 骨生成 ； RANKL單株抗體

並列摘要

Osteoporosis is an important health issue other than cardiovascular disease around the world and is the more common endocrine disease in aging people. Even though osteoporosis threatens people, however, it can be prevented and treated just like hypertension and hyperlipidemia. Osteoporosis is a bone disease caused by diminished bone density and deteriorated bone structure that leads to increased risk of fragility fractures. Osteoporosis is most commonly seen in postmenopausal women and elderly people. Medications for treating osteoporosis can be categorized into three classes according to their mechanisms: 1) Antiresorptive drugs:bisphosphonates, calcitonin, selective estrogen receptor modulators, and RANKL inhibitor. 2) Osteogenic agents:parathyroid hormone. 3) Mixed:strontium ranelate. They may be a preferred option for some patients for dosing convenience; however,calcium and vitamin D supplements will still need to be taken daily. All people, regardless of age and sex, should change to a bone-healthy lifestyle, which emphasizes the adequate intake for calcium and vitamin D, regular exercise, tobacco avoidance, and fall prevention to prevent and treat osteoporosis. Prevention and treatment of osteoporosis are therefore an important issue for today's aging society.

並列關鍵字

osteoporosis ； bisphosphonates ； RANKL inhibitor