双膦酸盐(bisphosphonate)是一类抗骨吸收药物,广泛应用于骨质疏松、恶性肿瘤骨转移等骨疾病的治疗,其严重的不良反应是发生药物相关性颌骨坏死(medication-related osteonecrosis of the jaw,MRONJ),临床表现为颌骨疼痛、骨面裸露、坏...双膦酸盐(bisphosphonate)是一类抗骨吸收药物,广泛应用于骨质疏松、恶性肿瘤骨转移等骨疾病的治疗,其严重的不良反应是发生药物相关性颌骨坏死(medication-related osteonecrosis of the jaw,MRONJ),临床表现为颌骨疼痛、骨面裸露、坏死等,严重影响患者口腔及全身健康。口腔诸多治疗均为侵入性操作,可能影响使用双膦酸盐患者的颌骨改建,引发MRONJ。对使用双膦酸盐的患者进行口腔治疗时,应规避MRONJ的危险因素,规范操作,降低MRONJ的发生风险。本文就使用双膦酸盐的患者如何进行规范化口腔治疗的研究进展作一综述,以期为口腔临床提供参考。展开更多
Objectives: Although bisphosphonates (BPs) are effective for the majority of patients with osteoporosis, some individuals do not adequately respond to these drugs. The objective of this study was to estimate the preva...Objectives: Although bisphosphonates (BPs) are effective for the majority of patients with osteoporosis, some individuals do not adequately respond to these drugs. The objective of this study was to estimate the prevalence of true BP non-responders who showed insufficient response after both oral BPs and intravenous ibandronate. Methods: Among 146 consecutive patients with postmenopausal osteoporosis who received oral BP monotherapy for more than 12 months, insufficient responders to oral BP monotherapy were switched to intravenous ibandronate injection and followed for more than 12 months. Serum N-terminal telopeptide of type I collagen (NTX) and bone alkaline phosphatase (BAP) concentrations were measured. Patients who also showed insufficient response to intravenous ibandronate were defined as true BP non-responders. Insufficient response to BP therapy was evaluated based on the serum NTX reduction cut-off for minimum significant change. Results: Sixty-one patients (41.8%) were diagnosed as oral BP non-responders. Fourteen patients who switched to intravenous ibandronate and had complete data available were used for final analysis. After switching to intravenous ibandronate, both NTX and BAP decreased significantly (p Conclusion: These results estimated that as few as 9% - 15% (i.e., 21.4% - 35.7% of 41.8%) or as many as 24% - 27% (i.e., 57.1% - 64.3% of 41.8%) of patents might be true BP non-responders.展开更多
文摘双膦酸盐(bisphosphonate)是一类抗骨吸收药物,广泛应用于骨质疏松、恶性肿瘤骨转移等骨疾病的治疗,其严重的不良反应是发生药物相关性颌骨坏死(medication-related osteonecrosis of the jaw,MRONJ),临床表现为颌骨疼痛、骨面裸露、坏死等,严重影响患者口腔及全身健康。口腔诸多治疗均为侵入性操作,可能影响使用双膦酸盐患者的颌骨改建,引发MRONJ。对使用双膦酸盐的患者进行口腔治疗时,应规避MRONJ的危险因素,规范操作,降低MRONJ的发生风险。本文就使用双膦酸盐的患者如何进行规范化口腔治疗的研究进展作一综述,以期为口腔临床提供参考。
文摘Objectives: Although bisphosphonates (BPs) are effective for the majority of patients with osteoporosis, some individuals do not adequately respond to these drugs. The objective of this study was to estimate the prevalence of true BP non-responders who showed insufficient response after both oral BPs and intravenous ibandronate. Methods: Among 146 consecutive patients with postmenopausal osteoporosis who received oral BP monotherapy for more than 12 months, insufficient responders to oral BP monotherapy were switched to intravenous ibandronate injection and followed for more than 12 months. Serum N-terminal telopeptide of type I collagen (NTX) and bone alkaline phosphatase (BAP) concentrations were measured. Patients who also showed insufficient response to intravenous ibandronate were defined as true BP non-responders. Insufficient response to BP therapy was evaluated based on the serum NTX reduction cut-off for minimum significant change. Results: Sixty-one patients (41.8%) were diagnosed as oral BP non-responders. Fourteen patients who switched to intravenous ibandronate and had complete data available were used for final analysis. After switching to intravenous ibandronate, both NTX and BAP decreased significantly (p Conclusion: These results estimated that as few as 9% - 15% (i.e., 21.4% - 35.7% of 41.8%) or as many as 24% - 27% (i.e., 57.1% - 64.3% of 41.8%) of patents might be true BP non-responders.
