経口ビスホスホネート治療の進歩と課題

New Development in Osteoporosis Treatment. Progress and problems in oral bisphosphnate.

　経口ビスホスホネート製剤は，エストロゲン製剤以外で骨粗鬆症による骨折の抑制をはじめて可能とした画期的なものである。これまで，骨吸収活性を高める方向と，内服回数を減らす方向で研究開発が進められてきた。一方で，稀ながら，長期使用に伴う顎骨壊死症や非定型骨折が生じることが明らかとなり，解決すべき課題となっている。

　Oral bisphosphonates are the first class of drugs other than estrogen that have been proven to reduce fracture incidence substantially. Since they are agents that inhibit bone resorption and are hardly absorbed through intestine, researchers have been focusing on augmentation of inhibitory effects of bisphosphonates on bone resorption and prolongation of the interval of drug administration. Even though they have a break-through efficacy on preventing fractures, there remain some rare problems to be solved, such as osteonecrosis of the jaw and atypical femoral fracture, after long-term exposure to bisphosphonates.