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Erschienen in: Zeitschrift für Rheumatologie 2/2022

10.01.2022 | Osteoporose | CME

Glukokortikoid-induzierte Osteoporose – Fokus Therapie (Teil 2)

verfasst von: Prof. Dr. med. Peter Oelzner, T. Eidner, A. Pfeil

Erschienen in: Zeitschrift für Rheumatologie | Ausgabe 2/2022

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Zusammenfassung

Für die Behandlung der Glukokortikoid-induzierten Osteoporose sind folgende Substanzen zugelassen: die oralen Bisphosphonate Alendronat und Risedronat, das intravenöse Bisphosphonat Zoledronat, der RANKL-Antikörper Denosumab als antiresorptiv wirksame Substanzen und Teriparatid als osteoanabole Substanz. Im Vergleich zu Placebo ist für alle genannten Substanzen eine Reduktion vertebraler Frakturen belegt. Dabei ist Teriparatid im Hinblick auf die Reduktion vertebraler Frakturen wirksamer als Alendronat und Risedronat. Schweregrad der Osteoporose, insbesondere das Vorliegen osteoporotischer Frakturen, der Ansatz der Therapie (präventiv oder kurativ) und das Vorliegen von Kontraindikationen sind Faktoren, die für den differenzierten Einsatz der genannten Substanzen von Bedeutung sind. Ferner muss beachtet werden, dass der Effekt einer osteoanabolen Therapie mit einer sich anschließenden antiresorptiven Therapie stabilisiert werden muss und dass nach Beendigung einer antiresorptiven Therapie mit Denosumab eine zeitlich befristete Bisphosphonattherapie erforderlich ist, um ein Reboundphänomen zu verhindern.
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Metadaten
Titel
Glukokortikoid-induzierte Osteoporose – Fokus Therapie (Teil 2)
verfasst von
Prof. Dr. med. Peter Oelzner
T. Eidner
A. Pfeil
Publikationsdatum
10.01.2022
Verlag
Springer Medizin
Erschienen in
Zeitschrift für Rheumatologie / Ausgabe 2/2022
Print ISSN: 0340-1855
Elektronische ISSN: 1435-1250
DOI
https://doi.org/10.1007/s00393-021-01128-7

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