porozendoОстеопороз и остеопатииOsteoporosis and Bone Diseases2072-26802311-0716Endocrinology Research Centre10.14341/osteo13143porozendo-13143Research ArticleНАУЧНЫЕ ОБЗОРЫREVIEWSДлительная терапия бисфосфонатами: обзор клинических исследованийLong-term therapy with bisphosphonates: review of clinical studieshttps://orcid.org/0000-0003-1886-124XМарченковаЛ. А.MarchenkovaL. A.

Марченкова Лариса Александровна - доктор медицинских наук, заведующий отделом соматической реабилитации, репродуктивного здоровья и активного долголетия, главный научный сотрудник.

121099, Москва, ул. Новый Арбат, д. 32

Researcher ID I-7220-2017; Scopus Author ID 57195620774

Larisa A. Marchenkova - Dr. Sci. (Med.).

121099, Moscow, Novy Arbat st., 32

Researcher ID I-7220-2017; Scopus Author ID 57195620774

marchenkovala@nmicrk.ruhttps://orcid.org/0000-0002-6526-4512ВасильеваВ. А.VasilevaV. A.

Васильева Валерия Александровна - к.м.н., заведующий отделением медицинской реабилитации взрослых для пациентов с соматическими заболеваниями №2, старший научный сотрудник отдела соматической реабилитации, репродуктивного здоровья и активного долголетия.

Москва

Scopus Author ID 57226068483

Valeriia A. Vasileva - Ph.D. (Med.).

Moscow

Scopus Author ID 57226068483

vasilevava@nmicrk.ruФГБУ «Национальный медицинский исследовательский центр реабилитации и курортологии» Минздрава РоссииРоссияNational Medical Research Center of Rehabilitation and BalneologyRussian Federation20231704202426447Copyright © Марченкова Л.А., Васильева В.А., 20242024Марченкова Л.А., Васильева В.А.Marchenkova L.A., Vasileva V.A.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.osteo-endojournals.ru/jour/article/view/13143

Целью настоящего научного литературного обзора было изучение клинических рекомендаций о длительности терапии бисфосфонатами у пациентов с остеопорозом, перенесшим патологические переломы, если они остаются в группе высокого риска после 3–5 лет их приема. Был проведен электронный поиск в базах данных, а также ручной поиск по журналам. Всего были изучены 94 публикации. В обзор были включены 17 публикаций. Сделан вывод, что длительная терапия алендронатом и золедроновой кислотой снижает риск переломов у женщин с остеопорозом. При длительном применении алендроната и золедроновой кислоты отмечается постоянный прирост минеральной плотности кости (МПК) в позвоночнике, однако после первоначального увеличения МПК бедра (total hip) и шейки бедренной кости через 2–3 года лечения бисфосфонатами достигается стойкое «плато», и дальнейший прирост МПК не происходит. Отсутствие значимой потери МПК и роста маркеров костного обмена является важным аспектом возможности лекарственных каникул у пациентов, получавших бисфосфонаты.

The purpose of this scientific literature review was to examine clinical recommendations for the duration of bisphosphonate therapy in patients with osteoporosis who have experienced osteoporotic fractures if they remain at high risk after 3–5 years of taking them. An electronic search of electronic databases was conducted, as well as a hand search of journals. A total of 94 publications were examined. 17 publications were included in the review. We concluded that patients who stopped taking bisphosphonates had a 20–40% higher risk of new clinical fractures and nearly twice the risk of vertebral fractures compared with the treatment period, indicating that a drug holiday is recommended not for all patients receiving therapy. However, long-term therapy with alendronate and zoledronic acid has been shown to reduce the risk of fractures in women with osteoporosis. The persistent increase in spinal bone mineral density with long-term bisphosphonate use may explain the lower incidence of vertebral fractures in patients on therapy long-term compared with patients who discontinued therapy after 3 years.

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