<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE root>
<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="research-article" dtd-version="1.2" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">Therapy</journal-id><journal-title-group><journal-title xml:lang="en">Therapy</journal-title><trans-title-group xml:lang="ru"><trans-title>Терапия</trans-title></trans-title-group></journal-title-group><issn publication-format="print">2412-4036</issn><issn publication-format="electronic">2713-1823</issn><publisher><publisher-name xml:lang="en">Bionika Media</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">288815</article-id><article-id pub-id-type="doi">10.18565/therapy.2022.2.77-85</article-id><article-categories><subj-group subj-group-type="toc-heading" xml:lang="en"><subject>Articles</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="ru"><subject>Статьи</subject></subj-group><subj-group subj-group-type="article-type"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title xml:lang="en">OSTEOPOROSIS: WHAT IS IMPORTANT FOR A PRIMARY CARE DOCTOR TO KNOW?</article-title><trans-title-group xml:lang="ru"><trans-title>ОСТЕОПОРОЗ: ЧТО ВАЖНО ЗНАТЬ ВРАЧУ ПЕРВИЧНОГО ЗВЕНА?</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>TOROPTSOVA</surname><given-names>Natalya V.</given-names></name><name xml:lang="ru"><surname>ТОРОПЦОВА</surname><given-names>Наталья Владимировна</given-names></name></name-alternatives><bio xml:lang="en"><p>MD, head of the Laboratory of osteoporosis</p></bio><bio xml:lang="ru"><p>д.м.н., зав. лабораторией остеопороза</p></bio><email>torop@irramn.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>NIKITINSKAYA</surname><given-names>Oksana A.</given-names></name><name xml:lang="ru"><surname>НИКИТИНСКАЯ</surname><given-names>Оксана Анатольевна</given-names></name></name-alternatives><bio xml:lang="en"><p>PhD, senior researcher of the Laboratory of osteoporosis</p></bio><bio xml:lang="ru"><p>к.м.н., старший научный сотрудник лаборатории остеопороза</p></bio><email>nikitinskaya@niir.su</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>DOBROVOLSKAYA</surname><given-names>Olga V.</given-names></name><name xml:lang="ru"><surname>ДОБРОВОЛЬСКАЯ</surname><given-names>Ольга Валерьевна</given-names></name></name-alternatives><bio xml:lang="en"><p>PhD, researcher of the Laboratory of osteoporosis</p></bio><bio xml:lang="ru"><p>к.м.н., научный сотрудник лаборатории остеопороза</p></bio><email>epid@irramn.ru</email><xref ref-type="aff" rid="aff1"/></contrib></contrib-group><aff-alternatives id="aff1"><aff><institution xml:lang="en">V.A. Nasonova Research Institute of Rheumatology</institution></aff><aff><institution xml:lang="ru">ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»</institution></aff></aff-alternatives><pub-date date-type="pub" iso-8601-date="2022-02-15" publication-format="electronic"><day>15</day><month>02</month><year>2022</year></pub-date><volume>8</volume><issue>2</issue><issue-title xml:lang="en">VOL 8, NO2 (2022)</issue-title><issue-title xml:lang="ru">ТОМ 8, №2 (2022)</issue-title><fpage>77</fpage><lpage>85</lpage><history><date date-type="received" iso-8601-date="2023-02-26"><day>26</day><month>02</month><year>2023</year></date></history><permissions><copyright-statement xml:lang="en">Copyright ©; 2022, Bionika Media</copyright-statement><copyright-statement xml:lang="ru">Copyright ©; 2022, ООО «Бионика Медиа»</copyright-statement><copyright-year>2022</copyright-year><copyright-holder xml:lang="en">Bionika Media</copyright-holder><copyright-holder xml:lang="ru">ООО «Бионика Медиа»</copyright-holder></permissions><self-uri xlink:href="https://journals.eco-vector.com/2412-4036/article/view/288815">https://journals.eco-vector.com/2412-4036/article/view/288815</self-uri><abstract xml:lang="en"><p>Osteoporosis occupies one of the leading places in morbidity structure of people over 50 years of age, and its social significance is associated with its main complications - low-energy fractures of the vertebral bodies and peripheral skeleton bones, treatment of which leads to high financial costs in healthcare. Article considers the modern criteria for diagnosing osteoporosis, presents a mandatory and additional laboratory examination of the patient to exclude other possible causes of bone mineral density decrease, as well as recommendations for choosing an antiosteoporotic medicine depending on the clinical picture of the disease and the risk of fractures. Recommendations concerning the duration of therapy depending on the used medicament and its efficacy, as well as indications for resuming treatment after a previous withdrawal are given.</p></abstract><trans-abstract xml:lang="ru"><p>Остеопороз занимает одно из ведущих мест в структуре заболеваемости лиц старше 50 лет, а его социальная значимость связана с основными осложнениями - низкоэнергетическими переломами тел позвонков и костей периферического скелета, лечение которых приводит к большим материальным затратам в области здравоохранения. В статье рассматриваются современные критерии диагностики остеопороза, представлены обязательное и дополнительное лабораторное обследование пациента для исключения других возможных причин снижения минеральной плотности костей, а также рекомендации по выбору антиостеопортического препарата в зависимости от клинической картины и риска переломов. Даны рекомендации по длительности терапии в зависимости от используемого препарата и его эффективности, а также показания для возобновления лечения после предшествующей отмены.</p></trans-abstract><kwd-group xml:lang="en"><kwd>low-energy fracture</kwd><kwd>fracture risk</kwd><kwd>osteoporosis</kwd><kwd>diagnosis of osteoporosis</kwd><kwd>treatment of osteoporosis</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>низкоэнергетический перелом</kwd><kwd>риск перелома</kwd><kwd>остеопороз</kwd><kwd>диагностика остеопороза</kwd><kwd>лечение остеопороза</kwd></kwd-group></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><mixed-citation>Лесняк О.М., Баранова И.А., Белова К.Ю. с соавт. Остеопороз в Российской Федерации: эпидемиология, медико-социальные и экономические аспекты проблемы (обзор литературы). Травматология и ортопедия России. 2018; 1: 155-168. doi: 10.21823/2311-2905-2018-24-1-155-168. https://dx.doi.org/10.21823/2311-2905-2018-24-1-155-168.</mixed-citation></ref><ref id="B2"><label>2.</label><mixed-citation>Добровольская О.В., Торопцова Н.В., Лесняк О.М. Экономические аспекты осложненного остеопороза: стоимость лечения в течение первого года после перелома. Современная ревматология. 2016; 3: 29-34. https://dx.doi.org/10.14412/1996-7012-2016-3-29-34.</mixed-citation></ref><ref id="B3"><label>3.</label><mixed-citation>Аудит состояния проблемы остеопороза - 2020. Доступ: https://osteoporosis-russia.ru/audit-sostoyaniya-problemy-osteoporoza-2020 (дата обращения - 1 1.02.2022).</mixed-citation></ref><ref id="B4"><label>4.</label><mixed-citation>Добровольская О.В., Торопцова Н.В. Постменопаузальный остеопороз: качество жизни пациенток после переломов. Эффективная фармакотерапия. 2015; 46: 8-13.</mixed-citation></ref><ref id="B5"><label>5.</label><mixed-citation>Белая Ж.Е., Белова К.Ю., Бирюкова Е.В. с соавт. Федеральные клинические рекомендации по диагностике, лечению и профилактике остеопороза. Остеопороз и остеопатии. 2021; 2: 4-47. https://dx.doi.org/10.14341/osteo12930.</mixed-citation></ref><ref id="B6"><label>6.</label><mixed-citation>Siminoski K., Jiang G., Adachi J.D. et al. Accuracy of height loss during prospective monitoring for detection of incident vertebral fractures. Osteoporos Int. 2005; 16(4): 403-10. https://dx.doi.org/10.1007/s00198-004-1709-z.</mixed-citation></ref><ref id="B7"><label>7.</label><mixed-citation>Остеопороз: руководство для врачей. Под ред. О.М. Лесняк. М.: ГЭОТАР-Медиа. 2016; 464 с. ISBN: 978-5-9704-3986-9.</mixed-citation></ref><ref id="B8"><label>8.</label><mixed-citation>Lindsay R., Silverman S.L., Cooper C. et al. Risk of new vertebral fracture in the year following a fracture. JAMA. 2001; 285(3): 320-23. https://dx.doi.org/10.1001/jama.285.3.320.</mixed-citation></ref><ref id="B9"><label>9.</label><mixed-citation>Gehlbach S., Saag K.G., Adachi J.D. et al. Previous fractures at multiple sites increase the risk for subsequent fractures: The global longitudinal study of osteoporosis in women. J Bone Miner Res. 2012; 27(3): 645-53. https://dx.doi.org/10.1002/jbmr.1476.</mixed-citation></ref><ref id="B10"><label>10.</label><mixed-citation>Dede A.D., Tournis S., Dontas I., Trovas G. Type 2 diabetes mellitus and fracture risk. Metabolism. 2014; 63(12): 1480-90. https://dx.doi.org/10.1016/j.metabol.2014.09.002</mixed-citation></ref><ref id="B11"><label>11.</label><mixed-citation>National Osteoporosis Foundation (NOF) and International Society for Clinical Densitometry (ISCD). Recommendations to DXA Manufacturers for FRAX® Implementation Guide. URL: http://www.nof.org/files/nof/public/content/resource/862/files/392.pdf (date of access - 11.02.2022).</mixed-citation></ref><ref id="B12"><label>12.</label><mixed-citation>Bauer D.C., Black D.M., Bouxsein M.L. et al. Foundation for the National Institutes of Health (FNIH) Bone Quality Project. Treatmentrelated changes in bone turnover and fracture risk reduction in clinical trials of anti-resorptive drugs: A meta-regression. J Bone Miner Res. 2018; 33(4): 634-42. https://dx.doi.org/10.1002/jbmr.3355.</mixed-citation></ref><ref id="B13"><label>13.</label><mixed-citation>Diez-Perez A., Adachi J.D., Agnusdei D. et al. IOF CSA Inadequate Responders Working Group. Treatment failure in osteoporosis. Osteoporos Int. 2012; 23(12): 2769-74. https://dx.doi.org/10.1007/s00198-012-2093-8.</mixed-citation></ref><ref id="B14"><label>14.</label><mixed-citation>Bauer D., Garnero P., Hochberg M. et al. Pretreatment levels of bone turnover and the antifracture efficacy of alendronate: The fracture intervention trial. J Bone Miner Res. 2005; 21(2): 292-99. https://dx.doi.org/10.1359/jbmr.051018.</mixed-citation></ref><ref id="B15"><label>15.</label><mixed-citation>Yamamoto T., Tsujimoto M., Hamaya E., Sowa H. Assessing the effect of baseline status of serum bone turnover markers and vitamin D levels on efficacy of teriparatide 20 mg/day administered subcutaneously in Japanese patients with osteoporosis. J Bone Miner Metab. 2013; 31(2): 199-205. https://dx.doi.org/10.1007/s00774-012-0403-z.</mixed-citation></ref><ref id="B16"><label>16.</label><mixed-citation>International Society for Clinical Densitometry. 2013 ISCD official positions - adult. URL: http://www.altecmedico.com/wp-content/ uploads/2016/02/2013-ISCD-Official-Positions-%E2%80%93-Adult.pdf (date of access - 11.02.2022).</mixed-citation></ref><ref id="B17"><label>17.</label><mixed-citation>Pepe J., Body J.J., Hadji P. et al. Osteoporosis in premenopausal women: A clinical narrative review by the ECTS and the IOF. J Clin Endocrinol Metab. 2020; 105(8): dgaa306. https://dx.doi.org/10.1210/clinem/dgaa306.</mixed-citation></ref><ref id="B18"><label>18.</label><mixed-citation>Rozenberg S., Bruyere O., Bergmann P. et al. How to manage osteoporosis before the age of 50. Maturitas. 2020; 138: 14-25. https://dx.doi.org/10.1016/j.maturitas.2020.05.004.</mixed-citation></ref><ref id="B19"><label>19.</label><mixed-citation>Lyles K.W., Colon-Emeric C.S., Magaziner J.S. et al. HORIZON Recurrent Fracture Trial. Zoledronic acid and clinical fractures and mortality after hip fracture. N Engl J Med. 2007; 357(18): 1799-809. https://dx.doi.org/10.1056/NEJMoa074941.</mixed-citation></ref><ref id="B20"><label>20.</label><mixed-citation>Мазуров В.И., Лесняк О.М., Белова К.Ю. с соавт. Алгоритмы выбора терапии остеопороза при оказании первичной медикосанитарной помощи и организации льготного лекарственного обеспечения отдельных категорий граждан, имеющих право на получение государственной социальной помощи. Системный обзор и резолюция экспертного совета российской ассоциации по остеопорозу. Профилактическая медицина. 2019; 1: 57-65.</mixed-citation></ref><ref id="B21"><label>21.</label><mixed-citation>Adler R., El-Hajj Fuleihan G., Bauer D. et al. Managing osteoporosis in patients on long-term bisphosphonate treatment: Report of a task force of the American Society for Bone and Mineral Research. J Bone Miner Res. 2016; 31(1): 16-35. https://dx.doi.org/10.1002/jbmr.2708.</mixed-citation></ref><ref id="B22"><label>22.</label><mixed-citation>Белая Ж.Е., Bilezikian J.P., Ершова О.Б. с соавт. Возможности длительной терапии постменопаузального остеопороза: обзор результатов клинических исследований деносумаба и резолюция совета экспертов российской ассоциации по остеопорозу (РАОП). Остеопороз и остеопатии. 2018; 1: 17-22. https://dx.doi.org/10.14341/osteo9760.</mixed-citation></ref><ref id="B23"><label>23.</label><mixed-citation>Gallagher J., Genant H., Crans G. et al. Teriparatide reduces the fracture risk associated with increasing number and severity of osteoporotic fractures. J Clin Endocrinol Metab. 2005; 90(3): 1583-87. https://dx.doi.org/10.1210/jc.2004-0826.</mixed-citation></ref><ref id="B24"><label>24.</label><mixed-citation>Orwoll E., Scheele W., Paul S. et al. The effect of teriparatide [Human Parathyroid Hormone (1-34)] therapy on bone density in men with osteoporosis. J Bone Miner Res. 2003; 18(1): 9-17. https://dx.doi.org/10.1359/jbmr.2003.18.1.9.</mixed-citation></ref><ref id="B25"><label>25.</label><mixed-citation>Saag K., Shane E., Boonen S. et al. Teriparatide or alendronate in glucocorticoid-induced osteoporosis. N Engl J Med. 2007; 357(20): 2028-39. https://dx.doi.org/10.1056/NEJMoa071408.</mixed-citation></ref><ref id="B26"><label>26.</label><mixed-citation>European Medicines Agency: Protelos/Osseor (strontium ranelate) to remain available but with further restrictions 15 April 2014 EMA 235924/2014. J Rheumatol. 2005; 32: 1556-62.</mixed-citation></ref><ref id="B27"><label>27.</label><mixed-citation>Richy F., Dukas L., Schacht E. Differential effects of D-hormone analogs and native vitamin D on the risk of falls: a comparative metaanalysis. Calcif Tissue Int. 2008; 82(2): 102-7. https://dx.doi.org/10.1007/s00223-008-9102-0.</mixed-citation></ref><ref id="B28"><label>28.</label><mixed-citation>Bone H.G., Wagman R.B., Brandi M.L. et al. 10 years of denosumab treatment in postmenopausal women with osteoporosis: results from the phase 3 randomised FREEDOM trial and open-label extension. Lancet Diabetes Endocrinol. 2017; 5(7): 513-23. https://dx.doi.org/10.1016/S2213-8587(17)30138-9.</mixed-citation></ref><ref id="B29"><label>29.</label><mixed-citation>Silverman S.L., Kupperman E.S., Bukata S.V. et al. Fracture healing: A consensus report from the International Osteoporosis Foundation Fracture Working Group. Osteoporos Int. 2016; 27(7): 2197-206. https://dx.doi.org/10.1007/s00198-016-3513-y.</mixed-citation></ref><ref id="B30"><label>30.</label><mixed-citation>Malouf-Sierra J., Tarantino U., Garcia-Hernandez P.A. et al. Effect of teriparatide or risedronate in elderly patients with a recent pertrochanteric hip fracture: Final results of a 78-week randomized clinical trial. J Bone Miner Res. 2017; 32(5): 1040-51. https://dx.doi.org/10.1002/jbmr.3067.</mixed-citation></ref></ref-list></back></article>
