mrjСовременная ревматологияModern Rheumatology Journal1996-70122310-158XIMA-PRESS, LLC10.14412/1996-7012-2018-4-59-64mrj-863Research ArticleОБЗОРЫREVIEWSЛечение больных остеопорозом: вопросы длительности , приверженности и замены терапииTreatment of patients with osteoporosis: issues of therapy duration, adherence, and replacementТоропцоваН. В.ToroptsovaN. V.

Наталья Владимировна Торопцова.

115522, Москва, Каширское шоссе, 34А.

Natalia Vladimirovna Toroptsova.

34A, Kashirskoe Shosse, Moscow 115522.

torop@irramn.ruФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой».РоссияV.A. Nasonova Research Institute of Rheumatology.Russian Federation2018061220181245964Copyright © Торопцова Н.В., 20182018Торопцова Н.В.Toroptsova N.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://mrj.ima-press.net/mrj/article/view/863

Остеопороз – хроническое заболевание, требующее длительного лечения, направленного на уменьшение риска низкоэнергетических переломов на фоне улучшения качества и прочности костей при приеме того или иного лекарственного средства. Бисфосфонаты (БФ) депонируются в кости, вследствие чего обладают эффектом последействия. В связи с увеличением риска нежелательных реакций на фоне приема БФ рассматривается возможность перевода пациентов на «лекарственные каникулы» или альтернативную терапию. Деносумаб может применяться непрерывно годами и в отличие от БФ не требует прекращения в лечении. Он эффективен как у не леченных ранее пациентов, так и у получавших ранее терапию БФ. В то же время при прекращении лечения действие деносумаба обратимо, поэтому для поддержания достигнутого эффекта рекомендуется прием пероральных БФ или внутривенное введение золедроновой кислоты.

Osteoporosis is a chronic disease requiring long-term treatment aimed at reducing the risk of low-energy fractures, by improving the quality and strength of bones when taking this or that drug. Bisphosphonates (BPs) are deposited in the bone, so that they have an aftereffect. Due to the increased risk of adverse reactions with BPs, the author considers that the patients may take a drug holiday or be switched to alternative therapy. Denosumab may be used continuously for years and, unlike BPs, does not require discontinuation. It is effective in both untreated and already BP-treated patients. At the same time, when the treatment is discontinued, the effect of denosumab is reversible; therefore, oral BP or intravenous zoledronic acid is recommended to maintain the achieved effect.

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