Transcript strontium ranelate in osteoporosis

骨質疏鬆症
骨質疏鬆症的危險因子
體型瘦小
Bone modeling and remodeling
Bone modeling
 Child and adolescent
 Non-coupling : bone formation and
resorption occur on separate surfaces
Bone remodeling
 The replacement of old bone tissue by new
bone tissue in the adult skeleton
 Coupling
Osteoporosis 
imbalance in bone remodeling
Results in thinning
and eventual
loss of trabecular
connectivity
Definition of Osteoporosis
Osteoporosis is defined as a skeletal disorder characterized by
compromised bone strength predisposing a person to an increased risk of
fracture. Bone strength primarily reflects the integration of bone density
and bone quality.
NIH Consensus Conference
Normal bone
Osteoporosis
NIH Consensus Development Panel on Osteoporosis. JAMA 285:785-95, 2001
Osteoporosis

Primary osteoporosis


Older persons and women past
menopause in which bone loss is
accelerated over that predicted for age
and sex.
Secondary osteoporosis

Metabolic bone disease



Primary prevention

comprehensive measures against other
lifestyle-related diseases

Secondary prevention

hyperparathyroidism
multiple myeloma or metastatic
carcinoma

Malnutrition

Drug therapy

with corticosteroids

Prolonged immobilization

Weightlessness with space travel
Should target people at higher risk of
osteoporotic fractures
Neoplasia

Should provided all the people as

Tertiary prevention

Should be provided the patients and at
frail elderly people using medical or
long-term care insurance
Osteoporosis Tutorial
雙能量X光骨密度檢查
超音波
Factors affecting bone metabolism
Medical treatment for osteoporosis
Anti-resorptive agent
 Estrogen
 SERM
Raloxifene (Evista)
 Calcitonin
 Bisphosphonate
Alendronate (Fosamax)
Risedronate (Actonel)
Ibandronate (Bonviva)
( Bone resorption)
Anabolic agent
 PTH (cyclic use)
( Bone formation)
 Strontium ranelate
( Bone formation)
( Bone resorption)
Protos
OPG
NEJM 2004;350:459-468
AEs of strontium ranelate (Protos)
PROTOS
Placebo
p
Gastritis
3.6
5.5
0.066
Gastric ulcer
1.0
1.1
NS
Esophagitis
0.8
0.6
NS
Diarrhea
6.1
3.6
0.019
Symptoms (%)
•2g of strontuim ranelate mix with a glass of water and
drink immediately.
•Taken before bedtime or 2-h before/after the meals
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