Золедроновая кислота при остеопорозе и низкоэнергетических переломах, осложняющих его течение

Золедроновая кислота – аминосодержащий бисфосфонат третьего поколения, применяется для лечения больных остеопорозом более 15 лет. За эти годы многочисленные экспериментальные и клинические исследования доказали высокую эффективность препарата при остеопорозе как у женщин различных возрастных групп, так и у мужчин при первичном и вторичном остеопорозе, у пациентов с разной выраженностью потери массы костной ткани и степенью риска переломов. Доказано, что внутривенные инфузии золедроновой кислоты приводят к быстрому росту массы костной ткани, существенному снижению риска низкоэнергетических переломов тел позвонков, проксимального отдела бедренной кости и в целом невертебральных переломов. Тем не менее в последние годы использование препарата значительно снизилось, что связывают как с недостаточной осведомленностью врачей первичного звена о возможностях данного препарата, так и с опасением таких осложнений его применения, как атипичные переломы и остеонекроз челюстных костей. Представленный обзор предназначен для повышения знаний врачей относительно механизма действия золедроновой кислоты, схем назначения препарата при различных формах остеопороза и переломах на его фоне. На приведенном клиническом примере показана способность золедроновой кислоты увеличивать массу не только губчатой, но и кортикальной кости проксимального отдела бедренной кости, что повышает роль золедроновой кислоты в профилактике повторных переломов. Кроме этого, пролонгированный эффект препарата позволяет по достижении терапевтического эффекта снизить частоту назначения по принципу «лекарственных каникул», сократив экономические затраты и медико-социальную нагрузку.

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