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    What Drugs Are Used for Osteoporosis Treatment

    12 Mar 2017 г.

    Osteoporosis is a chronic, systemic, degenerative pathology of the musculoskeletal system occurring in case of calcium metabolism disorder and is characterized by the predominance of bone tissue destruction processes over its creation. As a result, bone strength decreases and the risk of fractures increases.

    Nowadays, due to the medical research statistics osteoporosis takes the fourth place of the most common non-communicable diseases. Diseases of the cardiovascular system, oncopathology and diabetes are ahead. The mortality and disability percentage from osteoporosis is very high, however, in case of complex, balanced treatment, it is possible not only to improve the patient’s state, normalize his motion activity, and minimize the risk of fractures, but also to inhibit bone resorption, and stimulate osteogenesis.

     

    Osteoporosis treatment landscape

    Osteoporosis treatment assumes the use of a wide range of medical procedures and pharmacologic agents, which, as a result, provide a long-lasting positive effect and normalize the patient’s quality of life. Among them:

    • elimination of disease causes resulted in metabolic and osseous system disorders;
    • pathogenetic treatment stimulating formation and inhibiting bone tissue resorption;
    • basic (symptomatic) therapy reducing pain: intake of pain-relievers, physiotherapy procedures, activation and optimization of motion activity, diet;
    • orthopedic and trauma treatment in case of possible complications after fractures.

     

    Drugs for osteoporosis treatment

    The osteoporosis medical treatment is multipurpose. The balanced intake of drugs normalizes metabolic processes, slows down bone tissue destruction and optimizes bone remodeling, as well as improves blood circulation, relieves pain, inhibits inflammatory state and stimulates immunity. The complex of drugs for the osteoporosis treatment includes:

    • drugs relieving pain and inflammatory state: Rheopyrin, Ortopheum, Ibuprofen, etc.;
    • drugs of complex effect: vitamin D, Calcium-D3 Nycomed, Osteochin;
    • drugs for suppression of bone tissue resorption: estrogens (Raloxifene), strontium agents, calcitonin, and bisphosphonates (Etidronate, Ibandronate, Zoledronate, Aclasta, KSICREAM);
    • drugs for osteogenesis stimulation: parathyroid hormones (Teriparatide), fluoride salts, chondrotropic hormones, and bisphosphonates (Etidronate, Zoledronate, Aclasta, KSICREAM).

     

    The role of bisphosphonates in osteoporosis treatment

    Bisphosphonates belong to a new group of drugs of powerful effect on bone tissue, preventing bone destruction and stimulating osteogenesis. Normally, bone tissue like other body tissues is constantly renewed. It becomes possible due to the balanced function of bone tissue creator cells (osteoblasts) and destructive cells (osteoclasts). In case of osteoporosis and some other bone diseases, the activity of osteoclasts prevails suppressing the recovery processes, while bisphosphonates regulate the number of osteoclasts, activating their self-destruction. In addition, they normalize calcium metabolism of bone tissue. The effect of bisphosphonates on bone tissue can vary significantly due to their chemical composition. Accordingly, there are the following groups of drugs:

    • on the basis of zoledronic acid (Zoledronate, Aclasta, Zometa), which selectively affect bone tissue, providing significant anti-tumor effect, suppressing bone resorption without undesired effect on the processes of its formation, mineralization and mechanical properties;
    • based on sodium ibandronate (Bonviva, Boniva, Bondronat), suppressing the activity of osteoclasts, without affecting their amount. Such drugs are most effective as prophylactic agents;
    • based on alendronic acid (Fosamax, Forosa, Ostalon), non-hormonal bone correctors of tissue metabolism, contributing to the formation of the correct bone structure;
    • nitrogen-free – simple bisphosphonates (Etidronate, Clodronate, Tiludronate).
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    All the above-mentioned drugs are available in form of pills and injections. We should also mention the advantages and positive effects of bisphosphonate drugs produced in form of gels and creams. They are used in complex therapy against osteoporosis providing a long-lasting positive effect and, at the same time, excluding possible side effects as in case of other drug forms. KSICREAM belongs to this group of drugs. It is an active regulator of calcium metabolism, relieving pain and eliminating the main causes of pain syndrome. This drug is very effective as a prophylactic agent.

    Professor of Bogomolets National Medical University, L.V. Degtyareva

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