No 10 (2014)

The article analyzes the testing of «PROMETHEUS» program of the Russian Association on Osteoporosis, aimed at secondary prevention of recurrent osteoporotic fractures (OF), on the base of a city polyclinic № 96, St. Petersburg. The data relating to similar foreign programs are presented. Based on the analysis of some indicators of the traumtological unit of this clinic in 2012, the urgency of creating and implementation of programs of secondary prevention of OF in clinical practice in the Russia is demonstrated. Routing scheme for specialized patients within hospitals, as well as the role and interaction of various outpatient physicians in its implementation are presented and discussed. Information on antiosteoporotic pharmacotherapy in the secondary prevention of OF is provided. It is established that secondary prevention of OF should be carried out on the basis of territorial outpatient health facilities according to the specially designed medical-economic standards.

A prospective comparative study in two comparable clinical groups of women with low-energy compression fractures of the vertebral bodies on the background of postmenopausal osteoporosis was performed; the study has shown comparable efficacy and safety of anti-osteoporotic pharmacotherapy with domestic generics Rezoklastin FS (5 mg/6.25 ml), and the original drug of zoledronic acid Aclasta (5 mg/100 ml). The use of Rezoklastin FS is accompanied by relatively lower incidence of influenza-like effect, a marked positive effect on bone mineral density, confirmed by the results of dual energy X-ray densitometry, as well as the ability to prevent the occurrence of repeated low-energy vertebral compression fractures at 1-year follow-up. This allows to recommend the domestic drug of zoledronic acid Rezoklastin FS as an effective medicine for the secondary prevention of repeated vertebral osteoporotic fractures in women with postmenopausal osteoporosis.

The problem of osteoporosis (OP) remains relevant for decades because of its high prevalence in the population and the growth of the number of osteoporotic fractures. Rheumatic diseases (RD) and glucocorticosteroids (GCS) used for their treatment remain one of the most common causes of secondary OP, which in turn complicates the course of RD. The mechanisms of the development of the secondary OP and the GCS-induced OP are analyzed. Russian and international recommendations for the prevention and treatment of this disease are presented. Special attention is paid to modern drugs for the treatment of OP.

Postmenopausal osteoporosis (OP) - a systemic skeletal disease characterized by low bone mass and microarchitectural defection of bone tissue, which leads to increased bone fragility, a one of the social problems in the developed countries [1]. OP incidence is increased with age, and complications associated are increased with increasing life expectancy. These problems are particularly relevant for women and determined by high prevalence among the population, multifactorial nature, high frequency of disability, and deaths in some cases [2]. Therefore, prevention of OP and reduction of fracture risk remains challenge for clinicians.