Información del artículo
La osteoporosis posmenopáusica es una enfermedad importante por sus repercusiones clínicas en morbilidad y mortalidad, que va en aumento con la mayor longevidad y las modificaciones negativas del estilo de vida de la población. Se revisa tanto su impacto clínico como el epidemiológico en la actualidad, señalando el papel de los factores de riesgo para el diagnóstico de esta afección, cuya definición entraña no sólo la pérdida de densidad mineral ósea, sino también alteraciones en la calidad del hueso. En los últimos años, el arsenal terapéutico para la osteoporosis se ha modificado sustancialmente con fármacos estudiados en ensayos clínicos aleatorizados, a doble ciego y controlados con placebo. Ello permite estudiar su efecto en las fracturas, que constituyen el dato más importante para su utilización. Teniendo en cuenta, por lo tanto, estos nuevos datos y los riesgos porcentuales de fracturas al cabo de 10 años en la población, se puede establecer los criterios terapéuticos que se analiza en esta revisión.
Palabras clave:
Densitometría ósea
Osteoporosis posmenopáusica
Antirresortivos
Anabólicos
Remodelado óseo
Postmenopausal osteoporosis carries substantial morbidity and mortality. The impact of this disease is currently increasing due to greater longevity and negative lifestyle modifications. We review the clinical and epidemiologic impact of postmenopausal osteoporosis, with special emphasis on the risk factors to be considered in the diagnosis of this disease, which involves not only low bone mineral density, but also alterations in bone quality.
In the last few years, the therapeutic arsenal available for the treatment of this disease has changed substantially with drugs that have been tested in randomized, double-blind, placebo-controlled clinical trials. These studies have allowed the effect of these drugs on fractures –the most important data for their use– to be studied. Therefore, taking into account these new reports, as well as the percentage 10-year risk of fracture among the population, therapeutic criteria can be established. These criteria are analyzed in the present review.
Key words:
Bone densitometry
Postmenopausal osteoporosis
Antiresorptive agents
Anabolic therapy
Bone remodeling
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