porozendoОстеопороз и остеопатииOsteoporosis and Bone Diseases2072-26802311-0716Endocrinology Research Centre10.14341/osteo2017258-62porozendo-9524Research ArticleКлинический случай (или краткое сообщение)Case reportПрименение деносумаба при различных вариантах течения остеопорозаDenosumab treatment in patients with different courses of osteoporosishttps://orcid.org/0000-0001-7041-0732РожинскаяЛюдмила ЯковлевнаRozhinskayaLiudmila Ya.

д.м.н., профессор

MD, PhD, professor

rozh@endocrincentr.ruhttps://orcid.org/0000-0002-9783-3599МамедоваЕлизавета ОктаевнаMamedovaElizaveta O.

research fellow

lilybet@mail.ruhttps://orcid.org/0000-0002-9314-7831ЛуценкоАлександр СергеевичLutsenkoAlexander S.some91@mail.ruhttps://orcid.org/0000-0002-4567-2412МалыгинаАнастасия АндреевнаMalyginaAnastasia A.malygina.aa@gmail.comhttps://orcid.org/0000-0002-6674-6441БелаяЖанна ЕвгеньевнаBelayaZhanna E.

д.м.н.

MD, PhD

jannabelaya@gmail.com<p>ФГБУ &laquo;Национальный медицинский исследовательский центр эндокринологии&raquo; Минздрава России</p>Россия<p>Endocrinology Research Centre</p>Russian Federation2017151220172025862Copyright &#x00A9; Рожинская Л.Я., Мамедова Е.О., Луценко А.С., Малыгина А.А., Белая Ж.Е., 20172017Рожинская Л.Я., Мамедова Е.О., Луценко А.С., Малыгина А.А., Белая Ж.Е.Rozhinskaya L.Y., Mamedova E.O., Lutsenko A.S., Malygina A.A., Belaya Z.E.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.osteo-endojournals.ru/jour/article/view/9524

В статье представлено описание трех клинических случаев успешного применения таргетного препарата для лечения остеопороза – деносумаба – у пациентов с различными формами остеопороза: постменопаузальным остеопорозом при неэффективности бисфосфонатов, остеопорозом смешанного генеза на фоне супрессивной терапии тиреоидными гормонами и ингибиторами ароматазы, остеопороз у мужчины на фоне первичного гиперпаратиреоза. Механизм действия деносумаба отличен от такового у бисфосфонатов: связываясь с лигандом рецептора активатора ядерного фактора каппа бета (RANKL), деносумаб предотвращает дифференцировку остеокластов из преостеокластов, и, тем самым, подавляет резорбцию костной ткани. В клинических исследованиях было показано, что деносумаб способствует дальнейшему приросту минеральной плотности костной ткани после лечения бисфосфонатами. Деносумаб применяется в России с 2012 года. Клиническая эффективность и безопасность применения позволяют отнести деносумаб к препаратам первой линии лечения остеопороза.

We present three clinical cases of successful osteoporosis treatment with denosumab in patients with different courses of osteoporosis: postmenopausal with bisphosphonates ineffectiveness, osteoporosis of mixed etiology in patient on thyroid stimulating hormone suppression and aromatase inhibitor therapy and a case of osteoporosis in a male caused by primary hyperparathyroidism. Mechanism of denosumab action is different from bisphosphonates: denosumab prevents osteoclast differentiation by binding to receptor activator of nuclear factor kappa-B ligand (RANKL) and thus suppressing bone resorption. Clinical trials showed that denosumab promotes further increase of bone mineral density after bisphosphonate treatment. Denosumab has been used in Russian Federation since 2012. Clinical effectiveness and safety profile make denosumab one of the first-line drugs for osteoporosis treatment.

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