Recomendaciones para el manejo de la osteoporosis

En la actualidad la osteoporosis se considera solamente como un riesgo de fractura y por lo tanto se debe analizar en compañía de otros riesgos para decidir la conveniencia del tratamiento. Es más importante considerar la calidad ósea que confiere la resistencia, en la que la densidad ósea es uno de los varios componentes junto con la microarquitectura, la matriz y el recambio óseo. El tratamiento de la osteoporosis se hace en forma individual, considerando la edad y el antecedente de fractura, para así seleccionar varios recursos que se pueden agrupar en antiresortivos y anabólicos. Entre los primeros están los estrógenos, los bisfosfonatos y los moduladores selectivos del receptor de estrógenos como los principales; los anabólicos aún se encuentran en estudio y el más adelantado es la parathormona sintética. La administración de calcio y vitamina D no es suficiente para el tratamiento de la osteoporosis. El principal problema del tratamiento, que ha provocado una baja adherencia es el costo de los medicamentos y la falta de información sobre la necesidad de que el tratamiento sea a muy largo plazo.

Osteoporosis has to be considered only as a risk factor for bone fractures and its measurement by the bone mass index has some limitations. The aim of treatment of osteoporosis is to reduce the frequency of fractures (especially at the vertebral and the hip) which are responsible for morbidity and mortality with the osteoporosis. It has been demonstrated that antiresorptive drugs (bisphosphonates, estrogens, raloxifen) as well as anabolic agents (synthetic parathormone) are useful for preventing fractures. Calcium and vitamin D supplementation is not sufficient to treat persons with osteoporosis. Choice of treatment depends of age, the presence or absence of prevalent fractures, and the degree of bone mineral density measured at the spine and hip. The main inconvenient for the adherence of treatment is the high cost of the medicaments and agents as well as the poor information given to the patients.

Effect of raloxifen on postmenopausal osteoporosis / 中国康复理论与实践

@#ObjectiveTo observe the effect of raloxifen, a selective eastrogen receptor modulator, on postmenopausal osteoporosis.MethodsSixty six patients with postmenopausal osteoporosis were randomly divided into test group and control group with 33 cases in each group. Patients in the test group were treated with raloxifen (60 mg/day) for six months, at same time; cases in the control group were treated with placebo. Before and after treatment,routine laboratory examinations, transvaginal B type ultrasonic examination, and diagnostic curettage were performed. ResultsThe bone mineral densities of lumbar vertebrae and hip were significantly higher in the test group(60.6%) than in the control group(21.2%) (P<0.01). ConclusionRaloxifen is an effective medicine to treat postmenopausal osteoporosis, and it is also safe, without side effect of stimulating endometrim, etc.