雙磷酸鹽與骨質疏鬆症之治療

Bisphosphonates and Treatment of Osteoporosis

陳彥宇(Yan-Yu Chen) ； 楊榮森(Rong-Sen Yang)

《台灣老年醫學暨老年學雜誌》 6卷3期 (2011/08) Pp. 145-160

https://doi.org/10.29461/TGG.201108.0001

摘要

自1969年第一篇雙磷酸鹽對生物體的作用之研究發表以來，雙磷酸鹽的作用機制已逐漸明白，包括抑制三磷酸腺苷路徑與甲羥戊酸路徑，進而抑制骨再塑作用，減少骨量流失，使骨密度增高、骨折率降低等。然而除了對消化道的刺激與急性期反應等副作用外，長期使用雙磷酸鹽可能會抑制骨骼修補機制，使骨骼微小結構創傷累積，引發非典型骨折與顎骨缺血性壞死等，這些嚴重副作用讓學界重新檢視使用雙磷酸鹽的安全性。本文整理目前對雙磷酸鹽之生理藥理機轉、對骨骼代謝的影響、對骨質疏鬆症治療的效果與安全性等重要議題。

關鍵字

雙磷酸鹽 ； 骨質疏鬆症

並列摘要

Since the first publication on biological effects of bisphosphonates appeared in 1969, during the past forty years, the mechanism of bisphosphonates has become increasingly well established, including the inhibition of adenosine triphosphate pathway and mevalonate pathway, as well as reduction of bone remodeling that leads to increased bone mineral density and reduced fracture rates. However, in addition to gastrointestinal irritation and acute side effects, long term use of bisphosphonates could impair the bone repair function, accumulates microdamages, and increase the risk of atypical fractures and osteonecrosis of the jaw. These serious side effects have raised concerns about the safety of bisphosphonates. With the hope to benefit clinical practice, the article reviews current studies about the biochemical and pharmacological properties of bisphosphonates, effects on bone metabolism, therapeutic efficacy of osteoporosis treatment, and related safety issues.

並列關鍵字

Bisphosphonate ； Osteoporosis