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1、TherapeuticAdvancesinChronicDiseaseReviewBisphosphonatesforthetreatmentofTherAdvChronicDis(2010)1(3)115128DOI:10.1177/osteoporosis:insightsforclinicians2040622310374783!TheAuthor(s),2010.Reprintsandpermissions:E.MichaelLewieckihttp://www.sagepub.co.uk/journ
2、alsPermissions.navAbstract:Osteoporosisisacommonskeletaldiseasecharacterizedbyareductioninbonestrengthandincreasedriskoffractures.Osteoporoticfracturesareassociatedwithsubstantialmorbidity,mortality,andhighhealthcarecosts.Treatmentsforosteoporosishavebeensh
3、owntoincreasebonestrengthandreducefracturerisk.Thedrugsmostcommonlyusedtotreatosteoporosisarebisphosphonates:stableanalogsofnaturallyoccurringinorganicpyrophos-phate.Thebisphosphonatesshareacommonchemicalstructurewithsidechainvariationsthatconveydifferences
4、intheirpharmacologicalproperties,suchasaffinityforbonemineralandinhibitoryeffectonosteoclasticboneresorption.Theclinicalprofilesofbisphosphonates,suchastimeofonsetandoffsetofeffect,maydifferaccordingtothesepharmacologicalproperties.Bisphosphonatescanbeadmin
5、isteredorallyorintravenouslywithawiderangeofdosesanddosingintervals.Randomizedplacebo-controlledclinicaltrialshaveshownthatbisphospho-natesreducefractureriskinpostmenopausalwomenwithosteoporosisandhaveagenerallyexcellentsafetyrecord.Clinicalchallengesinusin
6、gbisphosphonatestotreatosteoporosisincludeappropriateselectionofpatientsforinitiatingtherapy,choosingwhichbisphosphonatetouse,monitoringtherapytoassurethatmedicationistakencorrectlyandthedesiredeffectisachieved,determiningwhendrugdiscontinuationshouldbecons
7、idered,andmanagingsideeffects,possiblesideeffects,andfearofsideeffects.Strategiesfortreatingpatientswithbisphosphonatesshouldconsidereachoftheseissues.Keywords:benefit,bisphosphonate,efficacy,osteoporosis,treatment,risk,safetyIntroductionwithstandardsforqua
8、litycontrolandclinicalCorrespondenceto:Osteoporosisisacommonsystemicskeletaldis-applicationestablishedbytheInternationalE.MichaelLewiecki,MD,FACP,FACEeasewithseriousclinicalconsequencesduetoSocietyforC
