Bisphosphonates are widely used in the treatment of osteoporosis in postmenopausal women and older men. In clinical trials they have been shown to reduce fractures in women with osteoporosis and there is increasing evidence that they are also effective in women with osteopenia, in whom the majority of fractures occur. In addition to their role as initial therapy in individuals at increased risk of fracture, bisphosphonates are used as sequential therapy after treatment with anabolic drugs. There are no head-to head studies to compare the anti-fracture efficacy of different bisphosphonates, but there is limited evidence that zoledronate treatment results in greater increases in BMD than risedronate or alendronate. This, together with the need for less frequent administration of zoledronate, supports its wider use in clinical practice, particularly if longer dosing intervals than those currently recommended are shown to be effective.

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双膦酸盐治疗骨质疏松症的实用指南

双膦酸盐广泛用于治疗绝经后女性和老年男性的骨质疏松症。在临床试验中，它们已被证明可以减少患有骨质疏松症的女性的骨折，并且越来越多的证据表明它们对大多数骨折发生的骨质减少症女性也有效。除了作为骨折风险增加的个体的初始治疗外，双膦酸盐还被用作合成代谢药物治疗后的序贯治疗。没有头对头的研究来比较不同双膦酸盐的抗骨折功效，但有限的证据表明唑来膦酸盐治疗导致 BMD 比利塞膦酸盐或阿仑膦酸盐增加更多。这一点，再加上唑来膦酸盐的给药频率较低，支持其在临床实践中的更广泛应用，