Österreichischer Leitfaden zur medikamentösen Therapie der postmenopausalen Osteoporose – Update 2009

  • Hans Peter Dimai
  • Peter Pietschmann
  • Heinrich Resch
  • Elisabeth Preisinger
  • Astrid Fahrleitner-Pammer
  • Harald Dobnig
  • Klaus Klaushofer
  • für die Austrian Society for Bone and Mineral Research (AuSBMR)
Themenschwerpunkt

Zusammenfassung

Die Osteoporose ist eine systemische Skeletterkrankung, die durch eine verminderte Knochenmasse sowie eine gestörte Mikroarchitektur des Knochens charakterisiert ist. Die Folge dieser Veränderungen ist eine eingeschränkte Knochenqualität mit einem entsprechend erhöhten Risiko für Frakturen. Oberstes Ziel jeder therapeutischen Intervention ist daher die Reduktion dieses erhöhten Frakturrisikos. Die Palette der in Österreich zur Therapie der postmenopausalen Osteoporose zugelassenen Pharmaka mit nachgewiesenem Potenzial zur Senkung des Frakturrisikos umfasst derzeit fünf Bisphosphonate (Alendronat, Risedronat, Etidronat, Ibandronat und Zoledronat), einen selektiven Östrogen-Rezeptormodulator (Raloxifen), zwei Parathormon-Analoga (1-34 PTH bzw. Teriparatid sowie 1-84 PTH), Strontiumranelat sowie Lachskalzitonin. Fluoride stehen theoretisch zur Verfügung, gelangen in der Praxis jedoch nicht mehr zur Anwendung. Es gibt keine Evidenz dafür, dass Kombinationstherapien Einzeltherapien überlegen sind. Im Anschluss an eine Therapie mit Parathormon-Analoga sollte jedoch eine antikatabole Therapie erfolgen. Eine adäquate Zufuhr von Kalzium und Vitamin D stellt ein wichtiges Adjunkt jeder Osteoporosetherapie dar.

Schlüsselwörter

Postmenopausale Osteoporose Leitfaden Medikamentöse Therapie 

Austrian guidance for the pharmacological treatment of osteoporosis in postmenopausal women – update 2009

Summary

Osteoporosis is a systemic skeletal disease characterized by diminished bone mass and deterioration of bone microarchitecture, leading to increased fragility and subsequent increased fracture risk. Therapeutic measures therefore aim at reducing individual fracture risk. In Austria, the following drugs, all of which have been proven to reduce fracture risk, are currently registered for the treatment of postmenopausal osteoporosis: alendronate, risedronate, etidronate, ibandronate, raloxifene, teriparatide (1-34 PTH), 1-84 PTH, strontium ranelate and salmon calcitonin. Fluorides are still available, but their role in daily practice has become negligible. Currently, there is no evidence that a combination of two or more of these drugs could improve anti-fracture potency. However, treatment with PTH should be followed by the treatment with an anticatabolic drug such as bisphosphonates. Calcium and vitamin D constitute an important adjunct to any osteoporosis treatment.

Keywords

Postmenopausal osteoporosis Guidance Pharmacological therapy 

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Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Hans Peter Dimai
    • 1
  • Peter Pietschmann
    • 2
    • 3
  • Heinrich Resch
    • 4
  • Elisabeth Preisinger
    • 5
  • Astrid Fahrleitner-Pammer
    • 1
  • Harald Dobnig
    • 1
  • Klaus Klaushofer
    • 6
    • 7
  • für die Austrian Society for Bone and Mineral Research (AuSBMR)
  1. 1.Klinische Abteilung für Endokrinologie und Nuklearmedizin, Universitätsklinik für Innere MedizinMedizinische Universität GrazGrazAustria
  2. 2.Institut für PathophysiologieMedizinische Universität WienWienAustria
  3. 3.Ludwig-Boltzmann-Institut für AltersforschungWienAustria
  4. 4.II. Medizinische AbteilungKrankenhaus der Barmherzigen SchwesternWienAustria
  5. 5.Institut für Physikalische Medizin und Rehabilitation, Krankenhaus HietzingWien, Sowie Osteoporose Selbsthilfe WienWienAustria
  6. 6.IV. Medizinische AbteilungHanusch-KrankenhausWienAustria
  7. 7.Ludwig-Boltzmann-Institut für OsteologieWienAustria

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