Download PDF
CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2021; 56(05): 550-557
DOI: 10.1055/s-0040-1714219
Artigo de Atualização
Osteometabólicas

Atualização do Tratamento Medicamentoso da Osteoporose

Article in several languages: português | English
Lindomar Guimarães Oliveira
1   Departamento de Ortopedia e Traumatologia, Universidade Federal de Goiás, Goiânia, GO, Brasil
,
Mara Lúcia Rassi Guimarães Carneiro
1   Departamento de Ortopedia e Traumatologia, Universidade Federal de Goiás, Goiânia, GO, Brasil
,
Márcio Passini Gonçalves de Souza
2   Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
,
Caio Gonçalves de Souza
2   Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
,
Frederico Barra de Moraes
1   Departamento de Ortopedia e Traumatologia, Universidade Federal de Goiás, Goiânia, GO, Brasil
,
Fábio Lopes de Camargo
1   Departamento de Ortopedia e Traumatologia, Universidade Federal de Goiás, Goiânia, GO, Brasil
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

Resumo

A população brasileira está envelhecendo, e com isso aumenta a prevalência de doenças crônico-degenerativas, dentre elas a osteoporose. O diagnóstico e tratamento da osteoporose teve avanços significativos na última década. O ortopedista e traumatologista não pode mais se deter apenas no tratamento cirúrgico da fratura osteoporótica. É extremamente importante que saibamos: 1) quais fatores de risco avaliar, podendo ser utilizada a ferramenta Fracture Risk Assesment Tool (FRAX, na sigla em inglês); 2) quais exames complementares solicitar, como densitometria, radiografia da coluna e bacia, exames de sangue e urina, e até mesmo biópsia óssea; 3) quais suplementos utilizar, como cálcio e magnésio, vitaminas D e K; 4) quais medicamentos prescrever, antirreabsortivos ou formadores, janelas terapêuticas e eventos adversos.

Palavras-chave

envelhecimento - osteoporose/diagnóstico - osteoporose/terapia


Publication History

Received: 03 February 2020

Accepted: 15 April 2020

Article published online:
28 October 2021

© 2021. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 

  • Referências

  • 1 Black DM, Rosen CJ. Clinical Practice. Postmenopausal Osteoporosis. N Engl J Med 2016; 374 (03) 254-262
    CrossrefPubMedGoogle Scholar
  • 2 de Souza MP. Osteoporosis Diagnosis and Treatment. Rev Bras Ortop 2010; 45 (03) 220-229
    CrossrefPubMedGoogle Scholar
  • 3 Stolnick B, Oliveira LG. Para que a primeira fratura seja a última. Rev Bras Ortop 2016; 51 (02) 121-126
    CrossrefPubMedGoogle Scholar
  • 4 Freedman BA, Potter BK, Nesti LJ, Cho T, Kuklo TR. Missed opportunities in patients with osteoporosis and distal radius fractures. Clin Orthop Relat Res 2007; 454 (454) 202-206
    CrossrefPubMedGoogle Scholar
  • 5 Souza BGSE, Carvalho LGVA, Oliveira LFMM, Ferreira AG, Amaral RCSD, Oliveira VM. Primary and secondary osteoporotic fractures prophylaxis: evaluation of a prospective cohort. Rev Bras Ortop 2017; 52 (05) 538-543
    Google Scholar
  • 6 Radominski SC, Bernardo W, Paula AP, Albergaria BH, Moreira C, Fernandes CE. Diretrizes brasileiras para o diagnóstico e tratamento da osteoporose em mulheres na pós-menopausa. Rev Bras Reumatol 2017; 57 (Suppl. 02) s452-s466
    CrossrefGoogle Scholar
  • 7 Oliveira LG, Guimarães ML. Male osteoporosis. Rev Bras Ortop 2015; 45 (05) 392-396
    Google Scholar
  • 8 Banefelt J, Åkesson KE, Spångéus A. et al. Risk of imminent fracture following a previous fracture in a Swedish database study. Osteoporos Int 2019; 30 (03) 601-609
    CrossrefPubMedGoogle Scholar
  • 9 Sousa CJ, Oliveira ML. Ferramenta FRAX no Brasil: revisão integrativa da literatura após sua Validação. Rev Bras Geriatr Gerontol 2018; 21 (01) 111-118
    Google Scholar
  • 10 Bauer DC. Clinical practice. Calcium supplements and fracture prevention. N Engl J Med 2013; 369 (16) 1537-1543
    CrossrefPubMedGoogle Scholar
  • 11 Peters BS, Martini LA. Nutritional aspects of the prevention and treatment of osteoporosis. Arq Bras Endocrinol Metabol 2010; 54 (02) 179-185
    CrossrefPubMedGoogle Scholar
  • 12 Chen LR, Wen YT, Kuo CL, Chen KH. Calcium and Vitamin D Supplementation on Bone Health: Current Evidence and Recommendations. Int J Gerontol 2014; 8: 183-188
    CrossrefGoogle Scholar
  • 13 Kanis JA, Cooper C, Rizzoli R, Reginster JY. Scientific Advisory Board of the European Society for Clinical and Economic Aspects of Osteoporosis (ESCEO) and the Committees of Scientific Advisors and National Societies of the International Osteoporosis Foundation (IOF). European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int 2019; 30 (01) 3-44
    CrossrefPubMedGoogle Scholar
  • 14 Maeda SS, Borba VZ, Camargo MB. et al. Brazilian Society of Endocrinology and Metabology (SBEM). Recommendations of the Brazilian Society of Endocrinology and Metabology (SBEM) for the diagnosis and treatment of hypovitaminosis D. Arq Bras Endocrinol Metabol 2014; 58 (05) 411-433
    CrossrefPubMedGoogle Scholar
  • 15 Qaseem A, Forciea MA, McLean RM, Denberg TD. Clinical Guidelines Committee of the American College of Physicians. Treatment of Low Bone Density or Osteoporosis to Prevent Fractures in Men and Women: A Clinical Practice Guideline Update From the American College of Physicians. Ann Intern Med 2017; 166 (11) 818-839
    CrossrefPubMedGoogle Scholar
  • 16 Matzkin EG, DeMaio M, Charles JF, Franklin CC. Diagnosis and Treatment of Osteoporosis: What Orthopaedic Surgeons Need to Know. J Am Acad Orthop Surg 2019; 27 (20) e902-e912
    CrossrefPubMedGoogle Scholar
  • 17 Watts NB, Diab DL. Long-term use of bisphosphonates in osteoporosis. J Clin Endocrinol Metab 2010; 95 (04) 1555-1565
    CrossrefPubMedGoogle Scholar
  • 18 Maeda SS, Lazaretti-Castro M. An overview on the treatment of postmenopausal osteoporosis. Arq Bras Endocrinol Metabol 2014; 58 (02) 162-171
    CrossrefPubMedGoogle Scholar
  • 19 Khan AA, Morrison A, Hanley DA. et al. International Task Force on Osteonecrosis of the Jaw. Diagnosis and management of osteonecrosis of the jaw: a systematic review and international consensus. J Bone Miner Res 2015; 30 (01) 3-23
    CrossrefPubMedGoogle Scholar
  • 20 Black DM, Bauer DC, Schwartz AV, Cummings SR, Rosen CJ. Continuing bisphosphonate treatment for osteoporosis--for whom and for how long?. N Engl J Med 2012; 366 (22) 2051-2053
    CrossrefPubMedGoogle Scholar
  • 21 Zanatta LB, Marcattoa C, Ramosa CS, Manasa N, Moreira C, Borba V. Uso de pamidronato para tratamento da osteoporose no sistema público de saúde no Brasil. Rev Bras Reumatol 2017; 57 (06) 514-520
    CrossrefGoogle Scholar
  • 22 Kates SL, Ackert-Bicknell CL. How do bisphosphonates affect fracture healing?. Injury 2016; 47 (01 Suppl 1): S65-S68
    CrossrefPubMedGoogle Scholar
  • 23 Oliveira LG, Eis SR, Neto HM, de Moraes FB, Pires LA, Vasconcelos JW. Use of risedronate for consolidation and callus formation in Colles fractures in postmenopausal women: SOLID study. Rev Bras Ortop 2015; 50 (03) 274-282
    Google Scholar
  • 24 Cummings SR, Ferrari S, Eastell R. et al. Vertebral Fractures After Discontinuation of Denosumab: A Post Hoc Analysis of the Randomized Placebo-Controlled FREEDOM Trial and Its Extension. J Bone Miner Res 2018; 33 (02) 190-198
    CrossrefPubMedGoogle Scholar
  • 25 Protocolos clínicos e diretrizes terapêuticas: volume 3 / Ministério da Saúde, Secretaria de Atenção à Saúde. Brasília: Ministério da Saúde; 2014. Disponível em: http://portalsaude.saude.gov.br/index.php/o-ministerio/principal/leia-mais-oministerio/840-sctie-raiz/daf-raiz/cgceaf-raiz/cgceaf/l3-cgceaf/11646-pcdt
    Google Scholar
  • 26 Chesnut III CH, Silverman S, Andriano K. et al. PROOF Study Group. A randomized trial of nasal spray salmon calcitonin in postmenopausal women with established osteoporosis: the prevent recurrence of osteoporotic fractures study. Am J Med 2000; 109 (04) 267-276
    CrossrefPubMedGoogle Scholar
  • 27 Haas AV, LeBoff MS. Osteoanabolic Agents for Osteoporosis. J Endocr Soc 2018; 2 (08) 922-932
    CrossrefPubMedGoogle Scholar
  • 28 Neer RM, Arnaud CD, Zanchetta JR. et al. Effect of parathyroid hormone (1-34) on fractures and bone mineral density in postmenopausal women with osteoporosis. N Engl J Med 2001; 344 (19) 1434-1441
    CrossrefPubMedGoogle Scholar
  • 29 Pereira RM, Carvalho JF, Paula AP. et al. Diretrizes para prevenção e tratamento da osteoporose induzida por glicocorticoide. Rev Bras Reumatol 2012; 52 (04) 569-593
    CrossrefGoogle Scholar
  • 30 Iwata A, Kanayama M, Oha F, Hashimoto T, Iwasaki N. Effect of teriparatide (rh-PTH 1-34) versus bisphosphonate on the healing of osteoporotic vertebral compression fracture: A retrospective comparative study. BMC Musculoskelet Disord 2017; 18 (01) 148
    CrossrefPubMedGoogle Scholar
  • 31 Gonnelli S, Caffarelli C. Abaloparatide. Clin Cases Miner Bone Metab 2016; 13 (02) 106-109
    PubMedGoogle Scholar
  • 32 Cosman F, Hattersley G, Hu MY, Williams GC, Fitzpatrick LA, Black DM. Effects of Abaloparatide-SC on Fractures and Bone Mineral Density in Subgroups of Postmenopausal Women With Osteoporosis and Varying Baseline Risk Factors. J Bone Miner Res 2017; 32 (01) 17-23
    CrossrefPubMedGoogle Scholar
  • 33 McClung MR, Grauer A, Boonen S. et al. Romosozumab in postmenopausal women with low bone mineral density. N Engl J Med 2014; 370 (05) 412-420
    CrossrefPubMedGoogle Scholar