Barreira ME

Idioma: Español
Referencias bibliográficas: 29
Paginas: 63-72
Archivo PDF: 143.93 Kb.

RESUMEN

La acción de los bifosfonatos es inhibir o reducir la fase de reabsorción ósea en el proceso de remodelado; esencialmente su molécula es similar a la de un pirofosfato y de acuerdo a la posición de su átomo de carbono variará el compuesto y por lo tanto su forma de acción y efectos colaterales. La investigación de estos productos actualmente lleva tres generaciones, desde la administración pura del bifosfonato por vía oral, pasando por el bifosfonato asociado a colecalciferol y a medicamentos para administración parenteral. Esto permite elegir entre una amplia gama de compuestos, el que mejor se adapte y funcione para cada paciente. El efecto indirecto más importante de estos medicamentos es la reducción del riesgo de fracturas en el paciente con osteoporosis. Sin embargo, es preciso considerar que el tiempo de administración debe ser, en la mayoría de los productos orales, por tiempo prolongado para que se logre el efecto deseado. Los medicamentos parenterales ofrecen la ventaja de requerir una sola dosis al año, pero por sus efectos colaterales su indicación está limitada y deben administrarse con sumo cuidado.

REFERENCIAS (EN ESTE ARTÍCULO)

1. Rodan GA. Introduction to bone biology. Bone 1992; 13 Suppl 1:S3-6.

2. Robey PG. The biochemistry of bone. Endocrinol Metab Clin North Am 1989; 18: 859-876.

3. Lian JB, Coutts M, Canalis E. Studies of hormonal regulation of osteocalcin synthesis in cultured fetal rat calvariae. J Biol Chem 1985; 260(15): 8706-8713.

4. Marcus R, Kosek J, Pfefferbaum A, et al. Age-related loss of trabecular bone in premenopausal women. A biopsy study. Calcif Tissue Int 1983; 35: 406-412.

5. Fleisch H, Russell RGG, Francis MD. Diphosphonates inhibit hydroxyapatite dissolution in vitro and bone resorption in tissue culture and in vivo. Science 1969; 165 (899): 1262-1264.

6. Fleisch H. Biphosphonates: mechanisms of action. Endocr Rev 1998; 19(1): 80-100.

7. Black DM, Cummings SR, Karpf DB, et al. Randomized trial of effect of alendronate on risk of fracture in women with existing vertebral fractures. Fracture Intervention Trial Research Group. Lancet 1996; 348: 1535-1541.

8. Cummings SR, Black DM, Thompson DE, et al. Effect of alendronate on risk of fracture in women with low bone density but without vertebral fractures: results from the Fracture Intervention Trial. JAMA 1998; 280(24): 2077-2082.

9. Harris ST, Watts NB, Genant HK, et al. Effects of risedronate treatment on vertebral and nonvertebral fractures in women with postmenopausal osteoporosis: a randomized controlled trial. Vertebral Efficacy With Risedronate Therapy (VERT) Study Group. JAMA 1999; 282(14): 1344-1352.

10. Reginster J, Minne HW, Sorensen OH, et al. Randomized trial of the effects of risedronate on vertebral fractures in women with established postmenopausal osteoporosis. Vertebral Efficacy with Risedronate Therapy (VERT) Study Group. Osteoporos Int 2000; 11(1): 83-91.

11. Chesnut III CH, Skag A, Christiansen C, et al. Effects of oral ibandronate administered daily or intermittently on fracture risk in postmenopausal osteoporosis. J Bone Miner Res 2004; 19(8): 1241-1249.

12. Black DM, Delmas PD, Eastell R, et al. Once-yearly zoledronic acid for treatment of postmenopausal osteoporosis. N Engl J Med 2007; 356(18): 809-1822.

13. Chapurlat RD, Delmas PD. Drug insight: Biphosphonates for postmenopausal osteoporosis. Nat Clin Pract Endocrinol Metab 2006; 2(4): 211-219.

14. Fleisch H. Biphosphonates: mechanisms of action. Endocr Rev 1998; 19(1): 80-100.

15. Ridley AJ, Hall A. The small GTP-binding protein RHO regulates the assembly of focal adhesions and actin stress fibers in response to growth factors. Cell 1992 ; 70(3): 389-399.

16. Dunford JE, Thompson K, Coxon FP, et al. Structure-activity relationships for inhibition of farnesyl diphosphate synthase in vitro and inhibition of bone resorption in vivo by nitrogen-containing biphosphonates. J Pharmacol Exp Ther 2001; 296(2): 235-242.

17. Black DM, Schwartz AV, Ensrud KE, et al. Effects of continuing or stopping alendronate after 5 years of treatment: the Fracture Intervention Trial Long-term Extension (FLEX): a randomized trial. JAMA 2006; 296(24): 2927-2938.

18. Mellström DD, Sörensen OH, Goemaere S, et al. Seven years of treatment with risedronate in women with postmenopausal osteoporosis. Calcif Tissue Int 2004; 75(6): 462-468.

19. McCloskey E. Health-related quality of life in osteoporosis. Medicographia 2006; 28: 33-39.

20. Kanis JA, Burlet N, Cooper C, et al. European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int 2008; 19: 399-428.

21. Serge CIM, Goonaseelam CP, Papapoulus SE. Pharmacokinetics-Pharmacodynamics of Biphosphonates. Use of Optimization of Intermittent Therapy for Osteoporosis. Clin Pharmacokinet 2005; 44(6): 551-570.

22. Bock O, Felsenberg D. Biphosphonates in the management of the postmenopausal osteoporosis- optimizing efficacy in the clinical practice. Clin Intereven Aging 2008; 3(2): 279-97.

23. Coleman RE. Risks and Benefits of Biphosphonates. Br J Cancer 2008; 98(11): 1736-1740.

24. Russell RG, Watts NB, Ebetino FH, Rogers MG. Mechanisms of action of biphosphonates: similarities and differences and their potential influence on clinical efficacy. Osteoporosis Int 2008; 19(6): 733-759.

25. Delmas PD. The use of biphosphonates in the treatment of osteoporosis. Current Opn Rheumatol 2005; 17: 462-466.

26. Ruggiero SL, Mehrotra B, Rosenberg TJ, Engroff SL. Osteonecrosis of the jaws associated with the use of biphosphonates: a review of 63 cases. J Oral Maxillofac Surg 2004; 62(5): 527-534.

27. Pazianas M, Blumentals WA, Miller PD. Lack of association between oral biphosphonates and osteonecrosis using jaw surgery as a surrogate marker. Osteoporosis Int 2008; 19(6): 773-779.

28. Borgioli A, Viviani C, Duvina M, et al. Biphosphonated-related osteonecrosis of the jaw: clinical and physiopathological considerations. Therapeutics Clin Risk Man 2009; 5: 217-227.

29. Aspenberg P. Los bifosfonatos y las fracturas por fatiga. Rev Metab Oseo y Min 2010; 8(1): 19-23.