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首页> 外文期刊>Disease management and health outcomes >Prevention and Treatment of Osteoporosis in Postmenopausal Women Defining the Role of Alendronate
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Prevention and Treatment of Osteoporosis in Postmenopausal Women Defining the Role of Alendronate

机译：定义阿仑膦酸盐作用的绝经后妇女骨质疏松症的防治

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Postmenopausal osteoporosis is characterized by an increased rate of bone turnover accompanied by a reductionin bone mineral density (BMD) that results in an increased risk of fracture, especially of the vertebrae, hip, or wrist. Alendronate (Fosamax?, Fosamax Once-Weekly), an oral bisphosphonate that inhibits oste-oclast-mediated bone resorption and modulates bone metabolism, is a first-line therapy for the management of postmenopausal women with, or at risk of developing, osteoporosis.Alendronate produces sustained increases in BMD and reductions in bone turnover from baseline, and reduces the risk of vertebral, hip, wrist, and other fractures in women with postmenopausal osteoporosis. It also prevents bone loss, and reduces the risk of radiographic or clinical vertebral fracture in postmenopausal osteopenia. Provided administration instructions are followed, alendronate is generally well tolerated. Adverse events are usually transient and are associated with the upper gastrointestinal tract (abdominal pain, nausea, acid regurgitation, dyspepsia); moreover, the incidence of these adverse events with alendronate was similar to those with placebo. More serious events (esophagitis, gastric or duodenal ulceration or bleeding) are uncommon. Once-weekly formulations are as effective and as well tolerated as once-daily alendronate in postmenopausal women.Pharmacoeconomic evaluations suggest that alendronate is a viable treatment option in postmenopausal osteoporosis. The reduction in fracture-related healthcare utilization seen with alendronate results in decreased direct costs, including inpatient or long-term care. Markov state-transition models suggest that this could at least partially offset costs incurred with alendronate therapy. Treatment of women with osteoporosis aged 65 years and older, and postmenopausal women with a previous osteoporotic fracture, are cost-effective strategies. Alendronate is also likely to increase quality-adjusted life-years in any postmenopausal women with osteoporosis.In conclusion, clinical and economic data support the use of alendronate in postmenopausal osteoporosis. It effectively reduces bone turnover, increases BMD, and reduces the risk of osteoporotic fracture in postmenopausal women with established osteoporosis, especially older women with a higher risk of fracture. Although its cost effectiveness in postmenopausal women with osteopenia is not clearly established, alendronate is clinically effective in these patients. In addition, it is generally well tolerated when taken as recommended. Consequently, alendronate should be considered a therapy of choice in the prevention and treatment of osteoporosis in postmenopausal women.
机译：绝经后骨质疏松症的特征是骨转换率增加，同时骨矿物质密度（BMD）降低，导致骨折风险增加，尤其是椎骨，髋部或腕部骨折。阿仑膦酸盐（Fosamax ?，每周一次Fosamax）是一种口服双膦酸盐，可抑制破骨细胞介导的骨吸收并调节骨代谢，是治疗患有骨质疏松症或有骨质疏松症风险的绝经后妇女的一线治疗方法。阿仑膦酸盐会导致BMD持续升高，并且与基线相比骨吸收减少，并降低绝经后骨质疏松症女性椎体，髋部，腕部和其他骨折的风险。它还可以防止骨质流失，并降低绝经后骨质减少的X线或临床椎骨骨折的风险。遵循给药说明，阿仑膦酸盐一般耐受良好。不良事件通常是短暂的，并与上消化道有关（腹部疼痛，恶心，胃酸反流，消化不良）;此外，阿仑膦酸盐的这些不良事件的发生率与安慰剂相似。更严重的事件（食管炎，胃或十二指肠溃疡或出血）并不常见。绝经后妇女每周一次的制剂与每天一次阿仑膦酸盐一样有效且耐受性良好。药物经济学评估表明，阿仑膦酸盐是绝经后骨质疏松症的可行治疗选择。阿仑膦酸盐引起的与骨折相关的医疗保健利用的减少导致直接成本的降低，包括住院或长期护理。马尔可夫状态转换模型表明，这可以至少部分抵消阿仑膦酸盐治疗的费用。治疗65岁及65岁以上的骨质疏松症妇女以及以前患有骨质疏松性骨折的绝经后妇女是一种经济有效的策略。阿仑膦酸还可能增加任何绝经后骨质疏松妇女的质量调整寿命。总之，临床和经济数据支持阿仑膦酸在绝经后骨质疏松症中的应用。对于患有骨质疏松症的绝经后妇女，特别是骨折风险较高的老年妇女，它有效地减少了骨转换，增加了骨密度，并降低了骨质疏松性骨折的风险。尽管尚未明确确定其在绝经后骨质疏松妇女中的成本效益，但阿仑膦酸盐在这些患者中临床上有效。此外，按建议服用时，通常耐受性良好。因此，在绝经后妇女的骨质疏松症的预防和治疗中，应考虑选择阿仑膦酸盐治疗。

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