porozendoОстеопороз и остеопатииOsteoporosis and Bone Diseases2072-26802311-0716Endocrinology Research Centre10.14341/osteo13208porozendo-13208Research ArticleНаучный обзорReview«Неантиостеопорозные» эффекты бисфосфонатов: исследования последних лет и перспективыNon-antiosteoporotic effects of bisphosphonates: latest studies and prospectshttps://orcid.org/0000-0002-3026-5814НурлыгаяновР. З.NurlygaianovR. Z.

Нурлыгаянов Радик Зуфарович, к.м.н.

450008, Уфа, ул. Ленина, д. 3

Radik Z. Nurlygaianov, MD, PhD

3 Lenina Str., 450008, Ufa

radiknur@list.ruhttps://orcid.org/0000-0003-1916-3830МинасовТ. Б.MinasovT. B.

Минасов Тимур Булатович, д.м.н., профессор 

Уфа

Timur B. Minasov, MD, Dr. Sci. (Med.), Professor

Ufa

m004@yandex.ruБашкирский государственный медицинский университетРоссияBashkir State Medical UniversityRussian Federation2025110120262832433Copyright © Нурлыгаянов Р.З., Минасов Т.Б., 20262026Нурлыгаянов Р.З., Минасов Т.Б.Nurlygaianov R.Z., Minasov T.B.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.osteo-endojournals.ru/jour/article/view/13208

Бисфосфонаты, традиционно применяемые для лечения остеопороза, демонстрируют широкий спектр плейотропных эффектов, выходящих за рамки их антирезорбтивного действия на костную ткань. Настоящий обзор анализирует современные научные данные о «неантиостеопорозных» эффектах бисфосфонатов, полученные в исследованиях 2015–2024 гг. Установлено, что бисфосфонаты обладают выраженным анальгетическим действием, особенно эффективным при болевом синдроме, обусловленном костными метастазами. Противоопухолевые эффекты включают онкопротективное действие и прямое воздействие на опухолевые клетки через различные молекулярные механизмы. Кардиоваскулярные эффекты проявляются в кардиопротективном действии и влиянии на процессы сосудистой кальцификации. Показана эффективность препаратов при заболеваниях суставов, включая остеоартроз, хотя данные об эффективности при асептическом некрозе головки бедренной кости остаются противоречивыми. Перспективными направлениями являются применение в ортопедической хирургии для профилактики асептической нестабильности эндопротезов и разработка конъюгатов с антибактериальными препаратами для лечения остеомиелита. Инновационные подходы включают использование бисфосфонатов для таргетной доставки нейротрофических факторов при сенсоневральной тугоухости. Уникальность данного обзора заключается в комплексном анализе всего спектра неантиостеопорозных эффектов с акцентом на новейшие разработки и критическую оценку перспектив клинического внедрения с учетом соотношения пользы и риска.

Bisphosphonates, traditionally used to treat osteoporosis, demonstrate a wide range of pleiotropic effects that go beyond their antiresorptive action on bone tissue. This systematic review analyzes current scientific data on the non-antiosteoporotic effects of bisphosphonates obtained in studies from 2015 to 2024. It has been established that bisphosphonates have a pronounced analgesic effect, especially effective in pain syndrome caused by bone metastases. Antitumor effects include oncoprotective action and direct effects on tumor cells through various molecular mechanisms. Cardiovascular effects are manifested in cardioprotective action and influence on vascular calcification processes. The effectiveness of the drugs in joint diseases, including osteoarthritis, has been shown, although data on the effectiveness in aseptic necrosis of the femoral head remain contradictory. Promising areas include use in orthopedic surgery for the prevention of aseptic instability of endoprostheses and the development of conjugates with antibacterial drugs for the treatment of osteomyelitis. Innovative approaches include the use of bisphosphonates for targeted delivery of neurotrophic factors in sensorineural hearing loss. The uniqueness of this review lies in the comprehensive analysis of the entire spectrum of non-antiosteoporotic effects with an emphasis on the latest developments and a critical assessment of the prospects for clinical implementation, taking into account the benefit-risk ratio.

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