porozendoОстеопороз и остеопатииOsteoporosis and Bone Diseases2072-26802311-0716Endocrinology Research Centre10.14341/osteo12694porozendo-12694Research ArticleЛЕКЦИЯМедикаментозное лечение остеопороза после переломаOsteoporosis drug treatment after fracturehttps://orcid.org/0000-0002-4193-688XТкачеваОльга НиколаевнаTkachevaOlga N.

д.м.н., профессор

MD, PhD, professor

tkacheva@rgnkc.ruhttps://orcid.org/0000-0002-1216-0787БраиловаНаталия ВасильевнаBrailovaNatalia V.

к.м.н.

MD, PhD

n.kokshagina@mail.ruhttps://orcid.org/0000-0001-7891-6850ДудинскаяЕкатерина НаильевнаDudinskayaEkaterina N.

к.м.н.

MD, PhD

katharina.gin@gmail.comhttps://orcid.org/0000-0003-0816-4870КузнецоваВероника АндреевнаKuznesovaVeronika A.

студентка

Student

nik_k_ot@mail.ruФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России, Российский геронтологический научно-клинический центрРоссияPirogov Medical University, Russian Gerontology Clinical Research CenterRussian FederationФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава РоссииРоссияPirogov Medical UniversityRussian Federation2020040620212343036Copyright © Ткачева О.Н., Браилова Н.В., Дудинская Е.Н., Кузнецова В.А., 20212021Ткачева О.Н., Браилова Н.В., Дудинская Е.Н., Кузнецова В.А.Tkacheva O.N., Brailova N.V., Dudinskaya E.N., Kuznesova V.A.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.osteo-endojournals.ru/jour/article/view/12694

Распространенность остеопороза, особенно среди пожилого населения, увеличивается в геометрической прогрессии, что приводит к росту числа переломов и инвалидности. В результате появляются новые требования к антиостеопоротической терапии, связанные с влиянием ее не только на ремоделирование здоровой кости, но и на ускорение консолидации переломов. В статье представлен краткий обзор влияния различных антиостеопоротических препаратов на заживление переломов костей. Дана оценка консолидирующему действию антирезорбтивных препаратов — бисфосфонатов и деносумаба, анаболического препарата — терипаратида, моноклональных антител, блокирующих белок склеростин, стронция ранелата. Применение препаратов антирезорбтивного действия не повлияло, по данным литературы, на замедление консолидации после переломов различных участков скелета (бедра, позвонков, дистальных отделов лучевой кости). Введение анаболических препаратов, в частности терипаратида, сопровождается более быстрым заживлением переломов в сравнении со сроками естественной регенерации кости или приемом бисфосфонатов, вызывая улучшение формирования костной мозоли. Применение препаратов, блокирующих склеростин, также увеличивает образование костной массы и прочность кости. С учетом имеющихся данных можно сделать вывод о том, что переломы не должны рассматриваться как противопоказание к применению данных препаратов и быть причиной позднего начала медикаментозного лечения остеопороза.

The prevalence of osteoporosis, especially among the elderly, is increasing exponentially, leading to an increase in the number of fractures and disability. As a result, new requirements for anti-osteoporotic therapy appear, associated with its influence not only on the remodeling of healthy bone, but also on the acceleration of fracture consolidation. The article provides a brief overview of the effect of various anti-osteoporotic drugs on the healing of bone fractures. An assessment of the consolidating effect of antiresorptive drugs — bisphosphonates and denosumab, and anabolic drug — teriparatide, monoclonal antibodies blocking the protein sclerostin, strontium ranelate is given. The use of antiresorptive drugs did not affect, according to the literature, the slowing down of consolidation after fractures of various parts of the skeleton (hip, vertebrae, distal radius). The introduction of anabolic drugs, in particular teriparatide, is accompanied by faster healing of fractures in comparison with the timing of natural bone regeneration or the intake of bisphosphonates, causing an improvement in the formation of callus. The use of drugs that block sclerostin also increases bone formation and bone strength. Based on the available data, it can be concluded that fractures should not be considered as a contraindication to the use of these drugs and be the reason for the late initiation of drug treatment of osteoporosis.

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The authors declare that there are no conflicts of interest present.