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Vecchi e nuovi farmaci nella terapia dell’osteoporosi post-menopausale: quale sequenza di trattamento secondo il profilo di rischio individuale?

Sommario

La sequenza di trattamento dell’osteoporosi post-menopausale, anche nell’ottica della prevenzione delle fratture da fragilità, è discussa in questa rassegna in relazione al profilo di rischio individuale. L’uso dei farmaci attualmente disponibili (estrogeni, SERMs, bisfosfonati, denosumab e teriparatide) è discusso alla luce dei più rilevanti studi sugli effetti preventivi e terapeutici e sono illustrati anche farmaci attualmente non disponibili in Italia. Le diverse opzioni di trattamento sono infine discusse in base ai risultati di studi controllati.

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Bibliografia

  1. Nuti R, Brandi ML, Checchia G et al. (2019) Guidelines for the management of osteoporosis and fragility fractures. Intern Emerg Med 14(1):85–102

    Article  Google Scholar 

  2. Vignozzi L, Malavolta N, Villa P et al. (2019) Consensus statement on the use of HRT in postmenopausal women in the management of osteoporosis by SIE, SIOMMMS and SIGO. J Endocrinol Invest 42(5):609–618

    CAS  Article  Google Scholar 

  3. Taranta A, Brama M, Teti A et al. (2002) The selective estrogen receptor modulator raloxifene regulates osteoclast and osteoblast activity in vitro. Bone 30(2):368–376

    CAS  Article  Google Scholar 

  4. Yusuf AA, Cummings SR, Watts NB et al. (2018) Real-world effectiveness of osteoporosis therapies for fracture reduction in post-menopausal women. Arch Osteoporos 13(1):33

    Article  Google Scholar 

  5. Bone HG, Wagman RB, Brandi ML et al. (2017) 10 years of denosumab treatment in postmenopausal women with osteoporosis: results from the phase 3 randomised FREEDOM trial and open-label extension. Lancet Diabetes Endocrinol 5:513–523

    CAS  Article  Google Scholar 

  6. Neer RM, Arnaud CD, Zanchetta JR et al. (2001) Effect of parathyroid hormone (1-34) on fractures and bone mineral density in postmenopausal women with osteoporosis. N Engl J Med 344(19):1434–1441

    CAS  Article  Google Scholar 

  7. Hernandez AV, Pérez-López FR, Piscoya A et al. (2019) Comparative efficacy of bone anabolic therapies in women with postmenopausal osteoporosis: a systematic review and network meta-analysis of randomized controlled trials. Maturitas 129:12–22

    CAS  Article  Google Scholar 

  8. Shakeri A, Adanty C (2020) Romosozumab (sclerostin monoclonal antibody) for the treatment of osteoporosis in postmenopausal women: a review. J Popul Ther Clin Pharmacol 27(1):e25–e31

    PubMed  Google Scholar 

  9. McClung MR, O’Donoghue ML, Papapoulos SE et al. (2019) Odanacatib for the treatment of postmenopausal osteoporosis: results of the LOFT multicenter, randomized, double-blind, placebo-controlled trial and LOFT Extension study. Lancet Diabetes Endocrinol 7(12):899–911

    CAS  Article  Google Scholar 

  10. Song J, Jin Z, Chang F et al. (2014) Single and combined use of human parathyroid hormone (PTH) (1-34) on areal bone mineral density (aBMD) in postmenpausal women with osteoporosis: evidence based on 9 RCTs. Med Sci Monit 20:2624–2632

    Article  Google Scholar 

  11. Walker MD, Cusano NE, Sliney J Jr et al. (2013) Combination therapy with risedronate and teriparatide in male osteoporosis. Endocrine 44:237–246

    CAS  Article  Google Scholar 

  12. Cheng C, Wentworth K, Shoback DM (2020) New frontiers in osteoporosis therapy. Annu Rev Med 71:277–288

    CAS  Article  Google Scholar 

  13. Leder BZ, Tsai JN, Uihlein AV et al. (2014) Two years of denosumab and teriparatide administration in postmenopausal women with osteoporosis (The DATA Extension Study): a randomized controlled trial. J Clin Endocrinol Metab 99:1694–1700

    CAS  Article  Google Scholar 

  14. Tsai JN, Jiang LA, Lee H et al. (2017) Effects of teriparatide, denosumab, or both on spine trabecular microarchitecture in DATA-switch: a randomized controlled trial. J Clin Densitom 20(4):507–512

    Article  Google Scholar 

  15. Anastasilakis AD, Polyzos SA, Yavropoulou MP, Makras P (2020) Combination and sequential treatment in women with postmenopausal osteoporosis. Expert Opin Pharmacother 21(4):477–490

    CAS  Article  Google Scholar 

  16. Leder BZ (2018) Optimizing sequential and combined anabolic and antiresorptive osteoporosis therapy. JBMR Plus 2(2):62–68

    Article  Google Scholar 

  17. Del Puente A, Migliaccio S, Esposito A, Lello S, Ott S (2004) Therapy for postmenopausal osteoporosis. Ageing Clin Exp Res 16(Suppl 3):42–46.

    Google Scholar 

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Correspondence to Silvia Migliaccio.

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Gli autori Rachele Fornari, Emanuela A. Greco e Silvia Migliaccio dichiarano di non avere conflitti di interesse.

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Fornari, R., Migliaccio, S. & Greco, E.A. Vecchi e nuovi farmaci nella terapia dell’osteoporosi post-menopausale: quale sequenza di trattamento secondo il profilo di rischio individuale?. L'Endocrinologo 21, 451–457 (2020). https://doi.org/10.1007/s40619-020-00810-3

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Parole chiave

  • Osteoporosi
  • SERMs
  • TOS
  • Bisfosfonati
  • Denosumab
  • Teriparatide
  • Terapia sequenziale