骨鬆針劑新藥 降低腸胃副作用

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骨鬆針劑新藥 降低腸胃副作用

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隨著國內老年人口增加,骨質疏鬆症也成為國人常見的健康問題。根據中華民國骨科醫學會理事長陳文哲表示,國內50歲以上婦女,大約有3百萬人,其中近8成都是骨質疏鬆症的高風險族群。因此,建議停經婦女每年最好做一次骨質密度檢測,捍衛「骨本」。


根據國內統計,六十歲以上人口,有近20%患有骨質疏鬆症,其中,女性骨質密度比男性低,而越瘦小的人,骨質密度就越低;陳文哲指出,國內目前有近3百萬五十歲以上婦女,76%骨質檢測數質低於負1以上,達骨量不足程度,17%檢測數值低於負2.5以上,達到骨質疏鬆程度,代表約有50萬人隨時面臨骨折危機。


目前治療骨質疏鬆症多用健保給付雙磷酸鹽口服藥物「福善美」,不過,副作用較多,包括:腹痛、腹瀉、便秘、脹氣、胃酸逆流、消化不良等,而且必須每週服用一次,吃藥後還必須站立半個小時,造成不少病患因為不便而停藥。所以,目前國內已經有不少患者開始接受雙磷酸鹽針劑用藥,陳文哲表示,以針劑的方式注射,每三個月施打一次,除了快速方便,也較沒有副作用。但無論口服或針劑,患者腎功能檢測尿肌酸必須高於1.6,才能接受雙磷酸鹽針劑藥物治療。雙磷酸鹽針劑用藥目前健保並不給付,因此,每次療程都需要自付5200元的費用。
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Re: 骨鬆針劑新藥 降低腸胃副作用

文章 ccc »

我介紹患者打過一次
老年人要小心不漏針 很貴耶 (壓力)
TC
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Re: 骨鬆針劑新藥 降低腸胃副作用

文章 TC »

雙磷酸鹽針劑比口服容易引起下顎骨壞死, 要注意!

最近讀奧立佛薩克斯的書"鎢絲舅舅 -- 少年薩克斯的化學愛戀",
裡面提到工廠工人磷中毒的情形, 也是下顎骨壞死, 死時面容不
成人形. 不曉得為何含磷的物質特別喜歡攻擊下顎骨?

Ref :

Oral bisphosphonates may lower jaw necrosis risk

January 03, 2008

NEW YORK (Reuters Health) - A report in the Journal of the American Dental Association clarifies the risk of jaw osteonecrosis associated with bisphosphonates, which are used to prevent or slow the progression of osteoporosis.

Intravenous bisphosphonates strongly increase the risk of adverse jaw outcomes, but oral bisphosphonates tend to decrease the risk, the research shows. Intravenous bisphosphonates are usually used to treat bone cancer or severe cases of osteoarthritis.

"This is good news for the roughly 3 million Americans who take Fosamax, Actonel, Boniva or similar osteoporosis meds orally," senior author Dr. Athanasios Zavras, from the Harvard School of Dental Medicine in Boston, said in a statement.

In 2003, reports first surfaced linking intravenous bisphosphonate treatment with osteonecrosis of the jaw. This is a serious condition in which bone tissue dies, resulting in the loss or destruction of the jawbone. Symptoms may include pain, swelling or infection of the gums and jaw, gums that don't heal, loose teeth and numbness of the jaw.

Oral versions of these agents were initially thought to be safe until a report came out in May 2005 showing that 7 of 63 bisphosphonate users who developed the condition had been using oral forms.

To investigate further, the researchers analyzed medical claims from 714,217 patients with osteoporosis or cancer to determine the effect that bisphosphonate use had on the risk of three outcomes: inflammatory conditions of the jaw (including osteonecrosis), major jaw surgery because of necrosis (tissue death), or jaw surgery for a malignancy.

The results showed that intravenous bisphosphonate use increased the risk of inflammatory necrosis of the jaw by 4.0-fold in patients with osteoporosis and by 4.5-fold in those with cancer. Among patients with either condition who required surgery for necrosis, the risk increased by 7.8-fold and 6.8-fold, respectively. No significant increase in risk was associated with surgery for cancer.

By contrast, oral bisphosphonate use reduced the risk of inflammatory necrosis of the jaw by 35 percent in patients with osteoporosis. No significant effects of oral bisphosphonates were associated with surgery for necrosis in this patient group or for any of the adverse jaw outcomes in cancer patients.

"Our findings on intravenous bisphosphonates are consistent with the literature, which makes me confident that our findings on oral bisphosphonates are correct," Zavras stated. "We're currently recruiting patients for a clinical study to confirm them."

SOURCE: Journal of the American Dental Association, January 2008.
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