3.8 Review

Risks vs. benefits of switching therapy in patients with postmenopausal osteoporosis

期刊

EXPERT REVIEW OF ENDOCRINOLOGY & METABOLISM
卷 16, 期 5, 页码 217-228

出版社

ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD
DOI: 10.1080/17446651.2021.1956902

关键词

Bisphosphonates; denosumab; discontinuation; osteoporosis; rebound; romosozumab; selective estrogen receptor modulator; switching therapy; teriparatide

资金

  1. Ministry of Education, Culture, Sports, Science, and Technology of Japan [20K17948]
  2. Grants-in-Aid for Scientific Research [20K17948] Funding Source: KAKEN

向作者/读者索取更多资源

Switching therapy is an important strategy in the treatment of postmenopausal osteoporosis. Understanding the characteristics of each drug, including limitations, side effects, compliance, and fracture prevention abilities, is crucial. The order of drug administration is important when switching therapy, and routine monitoring should be continued to ensure effectiveness and safety.
Introduction: Osteoporosis is characterized by the fragility of bones, leading to fractures and, consequently, the deterioration of functional capacity and quality of life. Postmenopausal women, in particular, are prone to osteoporosis and often require anti-osteoporosis treatment. In the last few decades, various anti-osteoporosis drugs have been approved for clinical use. In an aging society, osteoporosis cannot be treated using a single agent; therefore, switching therapy is an important treatment strategy. Areas covered: This review covers switching therapy in patients with postmenopausal osteoporosis. It's extremely important to understand the characteristics of each drug including; limitations on the duration of use, side effects due to long-term use (such as atypical femur fracture and osteonecrosis of the jaw) or discontinuation (such as rebound phenomenon), compliance, and ability to prevent fractures. We review and summarize the risks and benefits of switching therapy. Expert opinion: When switching therapy, the order of drug administration is important. Routine monitoring should be continued after switching treatments. We recommend first using osteoanabolic agents in postmenopausal women with severe osteoporosis. In addition, identifying predictors of the efficacy and side effects of treatment may help prevent the inappropriate use of drugs for the treatment of osteoporosis.

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