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Osteoporose : dos bisfosfonatos até aos novos tratamentos promissores
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A prevalência da osteoporose está a aumentar no mundo devido ao envelhecimento populacional, tornando-se um encargo muito pesado para as sociedades, particularmente com as fraturas de fragilidade. Apesar de existirem fármacos estabelecidos há várias décadas, não existe uma terapêutica ideal a reduzir o risco de fraturas. Os diferentes efeitos adversos e ausência de certeza da eficácia a longo prazo levam à descontinuação frequente dos fármacos de 1ª linha pelos doentes. Todavia, existe uma constante necessidade de descobrir alternativas, especialmente nos doentes com risco grave de fraturas osteoporóticas. Os avanços na compreensão dos diferentes mecanismos de interação celular/molecular e particularmente na inibição de anticorpos específicos conduzem a novas descobertas com resultados promissores na redução do risco de fratura. Contudo, existe uma preocupação na comunidade científica sobre a sua segurança e mais estudos devem ser criados, com vista a produzir um fármaco eficaz a inibir a reabsorção óssea excessiva, ao mesmo tempo que tenha efeitos anabólicos duradouros. Esta revisão de literatura pretende sumarizar as atuais opções disponíveis para o tratamento da osteoporose, focando nas novas terapias emergentes aprovadas ou em aprovação nos Estados Unidos da América e Europa.
The prevalence of osteoporosis is increasing worldwide with population ageing, becoming a heavy burden for societies, particularly with fragility fractures. Although the drugs established several decades ago are effective, there is no perfect treatment at lowering fracture risk. Adverse effects and lack of certainty in long term efficiency frequently lead to an earlier discontinuation of first-line drugs by the patients. There is urgency in discovering alternatives, especially in patients with severe osteoporotic fracture risk. Advances in the understanding of different cellular/molecular pathways and in inhibition of specific antibodies lead to new discoveries with promising results in reducing fracture risk. However, there is a concern among the scientific community about its safety and further research is needed with the aim of creating a drug capable of inhibiting excessive bone reabsorption while having long-lasting anabolic effects. This review intends to summarize the currently available options for the treatment of osteoporosis, focusing on the emerging therapies approved/under approval in the United States and Europe.
The prevalence of osteoporosis is increasing worldwide with population ageing, becoming a heavy burden for societies, particularly with fragility fractures. Although the drugs established several decades ago are effective, there is no perfect treatment at lowering fracture risk. Adverse effects and lack of certainty in long term efficiency frequently lead to an earlier discontinuation of first-line drugs by the patients. There is urgency in discovering alternatives, especially in patients with severe osteoporotic fracture risk. Advances in the understanding of different cellular/molecular pathways and in inhibition of specific antibodies lead to new discoveries with promising results in reducing fracture risk. However, there is a concern among the scientific community about its safety and further research is needed with the aim of creating a drug capable of inhibiting excessive bone reabsorption while having long-lasting anabolic effects. This review intends to summarize the currently available options for the treatment of osteoporosis, focusing on the emerging therapies approved/under approval in the United States and Europe.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2019
Palavras-chave
Osteoporose Fraturas Anti-reabsortivo Anabólico Tratamento Abaloparatide Romosozumab Endocrinologia