2013, Número 3
<< Anterior Siguiente >>
Acta Med 2013; 11 (3)
Tratamiento de la osteoporosis en pacientes de alto riesgo: El manejo del internista
Aisa ÁA, Rosas CM, Reza OM, Díaz GE, Rodríguez WFL
Idioma: Español
Referencias bibliográficas: 61
Paginas: 137-144
Archivo PDF: 136.07 Kb.
RESUMEN
La osteoporosis es una enfermedad que se caracteriza por una fragilidad ósea secundaria a la disminución de la densidad mineral ósea, la cual condiciona un aumento importante de riesgo de presentar fracturas. Es definida por la OMS como una disminución de la densidad mineral ósea de -2.5 con respecto a la desviación estándar. La osteoporosis es una enfermedad multidisciplinaria que abarca a la población de pacientes del internista, razón por la que debe sospecharse, abordarse y tratarse de forma oportuna. Los bisfosfonatos son fármacos que han demostrado un importante aumento en la densidad mineral ósea, con un alto impacto en la prevención de fracturas vertebrales y de cadera. Éstos son los fármacos más prescritos en la consulta de medicina interna y son considerados de primera línea para el tratamiento contra la osteoporosis. En la actualidad, los fármacos de mayor empleo como tratamiento son el alendronato, el risedronato, el ibandronato y el ácido zoledrónico. Se han reportado complicaciones poco frecuentes pero graves posteriores al uso de bisfosfonatos, tales como la osteonecrosis de la mandíbula, cáncer de esófago y fracturas femorales atípicas, por lo que en la actualidad existe gran controversia acerca de su empleo.
REFERENCIAS (EN ESTE ARTÍCULO)
Whitaker M, Guo J, Kehoe T et al. Bisphosphonates for osteoporosis - where do we go from here? N Eng J Med. 2012; 10: 1056.
NIH Consensus Development Panel on osteoporosis prevention, diagnosis, and therapy. Osteoporosis prevention, diagnosis, and therapy. JAMA. 2001; 285: 785-795.
Bainbridge K, Sowers M, Lin X, Harlow SD. Risk factors for low bone mineral density and the 6-year rate of bone loss among premenopausal and perimenopausal women. Osteoporos Int. 2004; 15: 439.
Favus MJ. Bisphosphonates for osteoporosis. N Engl J Med. 2010; 363: 2027-2035.
Nelson HD, Helfand M, Woolf SH, Allan JD. Screening for postmenopausal osteoporosis: A review of the evidence for the US Preventive Services Task Force. Ann Intern Med. 2002; 137: 529-541.
National Osteoporosis Foundation. Osteoporosis: cost-effectiveness analysis and review of the evidence for prevention, diagnosis and treatment. Osteoporos Int 8. 1998; 10: S001-S080.
Jódar GE. Identificación del paciente con alto riesgo de fractura. Rev Osteoporos Metab Miner. 2010; 2(Supl 3): S12-21.
Kanis JA, Johnell O, Oden A, Johansson H, McCloskey E. FRAX™ and the assessment of fracture probability in men and women from the UK. Osteoporos Int. 2008; 19: 385-397.
Clinician’s guide to prevention and treatment of osteoporosis. Washington, DC: National Osteoporosis Foundation; 2008.
Hodgson SF, Watts NB, Bilezikian JP et al. American Association of Clinical Endocrinologists medical guidelines for clinical practice for the prevention and treatment of postmenopausal osteoporosis: 2001 edition, with selected updates for 2003. Endocr Pract. 2003; 9: 544- 564 [Erratum, Endocr Pract. 2004; 10: 90].
Qaseem A, Snow V, Shekelle P, Hopkins R Jr, Forciea MA, Owens DK. Pharmacologic treatment of low bone density or osteoporosis to prevent fractures: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2008; 149: 404-415.
American College of Obstetricians and Gynecologists Women’s Health Care Physicians. Osteoporosis. Obstet Gynecol. 2004; 104 Suppl: 66S-76S.
Russell RG, Watts NB, Ebetino FH, Rogers MJ. Mechanisms of action of bisphosphonates: similarities and differences and their potential influence on clinical efficacy. Osteoporos Int. 2008; 19: 733-759.
Gertz BJ, Holland SD, Kline WF et al. Studies of the oral bioavailability of alendronate. Clin Pharmacol Ther. 1995; 58: 288.
Agrawal S, Krueger DC, Engelke JA et al. Between-meal risedronate does not alter bone turnover in nursing home residents. J Am Geriatr Soc. 2006; 54: 790.
Ribeiro A, DeVault KR, Wolfe JT III, Stark ME. Alendronate-associated esophagitis: endoscopic and pathologic features. Gastrointest Endosc. 1998; 47: 525-528.
Markowitz GS, Fine PL, Stack JI et al. Toxic acute tubular necrosis following treatment with zoledronate (Zometa). Kidney Int. 2003; 64: 281.
Ack 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.
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: 2077.
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: 2927.
Rizzoli R, Greenspan SL, Bone G 3rd et al. Two-year results of onceweekly administration of alendronate 70 mg for the treatment of postmenopausal osteoporosis. J Bone Miner Res. 2002; 17: 1988.
Greenspan SL, Emkey RD, Bone HG et al. Significant differential effects of alendronate, estrogen, or combination therapy on the rate of bone loss after discontinuation of treatment of postmenopausal osteoporosis. A randomized, double-blind, placebo-controlled trial. Ann Intern Med. 2002; 137: 875.
Johnell O, Scheele WH, Lu Y et al. Additive effects of raloxifene and alendronate on bone density and biochemical markers of bone remodeling in postmenopausal women with osteoporosis. J Clin Endocrinol Metab. 2002; 87: 985.
Harris ST, Watts NB, Genant HK et al. Effects of risedronato 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: 1344-1352.
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: 83-91.
McClung MR, Geusens P, Miller PD et al; for Hip Intervention Program Study Group. Effect of risedronate on the risk of hip fracture in elderly women. N Engl J Med. 2001; 344: 333-340.
Harris ST, Watts NB, Li Z, Chines AA et al. Two-year efficacy and tolerability of risedronate once a week for the treatment of women with postmenopausal osteoporosis. Curr Med Res Opin. 2004; 20: 757-764 [Erratum in: Curr Med Res Opin. 2004; 20 (10): 1690].
Delmas PD, Benhamou CL, Man Z et al. Monthly dosing of 75 mg risedronate on 2 consecutive days a month: efficacy and safety results. Osteoporos Int. 2008; 19: 1039-1045.
Delmas PD, McClung MR, Zanchetta JR et al. Efficacy and safety of risedronate 150 mg once a month in the treatment of postmenopausal osteoporosis. Bone. 2008; 42: 36-42.
Siris ES, Harris ST, Rosen CJ et al. Adherence to bisphosphonate therapy and fracture rates in osteoporotic women: relationship to vertebral and nonvertebral fractures from 2 US claims databases. Mayo Clin Proc. 2006; 81: 1013-1022.
Reid IR, Brown JP, Buckhardt P et al. Intravenous zoledronic acid in postmenopausal women with low bone mineral density. N Engl J Med. 2002; 346: 653-661.
Grey A, Bolland MJ, Wattie D et al. The antiresortive effects of a single dose of zoledronate persist for two years: a randomized, placebo-controlled trial in osteopenic postmenopausal women. J Clin Endocrinol Metab. 2009; 94: 538.
Lyles KW, Colón-Emeric CS, Magaziner JS et al. Zoledronic acid and clinical fractures and mortality after hip fracture. N Engl J Med. 2007; 357: 1799.
Dennis M, Black D et al. Once-yearly zoledronic acid for treatment of postmenopausal osteoporosis. N Engl J Med. 2007; 356: 1809-1820.
Black DM, Reid IR, Boonen S et al. The effect of 3 versus 6 years of zoledronic acid treatment of osteoporosis: a randomized extension to the HORIZON-Pivotal Fracture Trial (PFT). J Bone Miner Res. 2012; 27: 243.
Watts NB, Diab DL. Long-term use of bisphosphonates in osteoporosis. J Clin Endocrinol Metab. 2010; 95: 1555.
Lewiecki EM, Bilezikian JP, Khosla S et al. Osteoporosis update from the 2010 Santa Fe bone symposium. J Clin Densitom. 2011; 14: 1.
Smith MR et al. Pamidronate to prevent bone loss during androgendeprivation therapy for prostate cancer. N Engl J Med. 2001; 345: 948-953.
Miller RG, Chretien KC, Meoni LA et al. Comparison of intravenous pamidronate to standard therapy for osteoporosis: use in patients unable to take oral bisphosphonates. J Clin Rheumatol. 2005; 11: 2.
Thiebaud D, Burckhardt P, Melchior J et al. Two years’ effectiveness of intravenous pamidronate (APD) versus oral fluoride for osteoporosis occurring in the postmenopause. Osteoporos Int. 1994; 4: 76-83.
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: 1241.
Pyon EY. Once-monthly ibandronate for postmenopausal osteoporosis: review of a new dosing regimen. Clin Ther. 2006; 28: 475.
US Food and Drug Administration. Highlights of prescribing information - Boniva [Internet]. Available in: http://www.accessdata.fda.gov/ drugsatfda_docs/label/2011/021455s011lbl.pdf [Accessed on March 29, 2012].
Reginster JY, Adami S, Lakatos P et al. Efficacy and tolerability of once-monthly oral ibandronate in postmenopausal osteoporosis: 2 year results from the MOBILE study. Ann Rheum Dis. 2006; 65: 654.
Eisman JA, Civitelli R, Adami S et al. Efficacy and tolerability of intravenous ibandronate injections in postmenopausal osteoporosis: 2-year results from the DIVA study. J Rheumatol. 2008; 35: 488.
Harris ST, Blumentals WA, Miller PD. Ibandronate and the risk of non-vertebral and clinical fractures in women with postmenopausal osteoporosis: results of a meta-analysis of phase III studies. Curr Med Res Opin. 2008; 24: 237.
Cranney A, Wells GA, Yetisir E et al. Ibandronate for the prevention of nonvertebral fractures: a pooled analysis of individual patient data. Osteoporos Int. 2009; 20: 291.
Delmas PD, Adami S, Strugala C et al. Intravenous ibandronate injections in postmenopausal women with osteoporosis: one-year results from the dosing intravenous administration study. Arthritis Rheum. 2006; 54: 1838.
Cummings SR, San Martin J, McClung MR, Siris ES, Eastell R, Reid IR et al. Denosumab for prevention of fractures in postmenopausal women with osteoporosis. N Engl J Med. 2009; 361(8): 756-65.
Hillel N Rosen. Calcium and vitamin D supplementation in osteoporosis. UPTODATE®. Last update: maig. 2011.
Bone HG, Bolognese MA, Yuen CK, Kendler DL, Wang H, Liu Y et al. Effects of denosumab on bone mineral density and bone turnover in postmenopausal women. J Clin Endocrinol Metab. 2008; 93(6): 2149-2157.
Papapoulos S, Chapurlat R, Libanati C, Brandi ML, Brown JP, Czerwinski E et al. Five years of denosumab exposure in women with postmenopausal osteoporosis: results from the first two years of the FREEDOM extension. J Bone Miner Res. 2011. Doi: 10.1002/ jbmr.1479.
Reid IR, Mason B, Horne A et al. Effects of calcium supplementation on serum lipid concentrations in normal older women: a randomized controlled trial. Am J Med. 2002; 112: 343.
Chapuy MC, Arlot ME, Delmas PD, Meunier PJ. Effect of calcium and cholecalciferol treatment for three years on hip fractures in elderly women. BMJ. 1994; 308: 1081-1082.
Johnston CC Jr, Miller JZ, Slemenda CW et al. Calcium supplementation and increases in bone mineral density in children. N Engl J Med. 1992; 327: 82.
Chapuy MC, Arlot ME, Duboeuf F et al. Vitamin D3 and calcium to prevent hip fractures in the elderly women. N Engl J Med. 1992; 327: 1637.
O’Donnell S, Cranney A, Wells GA et al. Strontium ranelate for preventing and treating postmenopausal osteoporosis. Cochrane Database Syst Rev. 2006; 3: CD005326.
Barrett-Connor E, Mosca L, Collins P et al. Effects of raloxifene on cardiovascular events and breast cancer in postmenopausal women. N Engl J Med. 2006; 355: 125.
Neer RM, Arnaud CD, Zanchetta JR et al. Effect of parathyroid hormone (1-34) on fractures and bone mineral density in postmenopausal women with osteoporosis. N Engl J Med. 2001; 344: 1434.
Greenspan SL, Bone HG, Ettinger MP et al. Effect of recombinant human parathyroid hormone (1-84) on vertebral fracture and bone mineral density in postmenopausal women with osteoporosis: a randomized trial. Ann Intern Med. 2007; 146: 326.
Vahle JL, Sato M, Long GG et al. Skeletal changes in rats given daily subcutaneous injections of recombinant human parathyroid hormone (1-34) for 2 years and relevance to human safety. Toxicol Pathol. 2002; 30: 312.