ステロイド性骨粗鬆症に対するテリパラチドの効果

Glucocorticoid and Bone. Beneficial effect of teriparatide on fracture risk as well as bone mineral density in patients with glucocorticoid-induced osteoporosis.

　ステロイド性骨粗鬆症では一過性の骨吸収増加と持続的な骨形成低下があり，骨形成促進作用を有するテリパラチドはこの病態改善に適した骨粗鬆症治療薬である。ステロイド性骨粗鬆症の管理と治療ガイドライン（2014年改訂版）において，国内外の治療成績をもとに，腰椎および大腿骨骨密度の増加と椎体骨折の二次予防効果を認めた遺伝子組換えテリパラチドが，第１選択薬の代替え治療薬のひとつに位置づけられた。

　Bone metablism of glucocorticoid-induced osteopororsis（GIO）is characterised by transient increase in bone resorption and persistent suppression of bone formation caused by glucocorticoid. Teriparatide is an ideal drug for GIO, because of antagonistic effect against that pathophysiological conditions. Based on new findings of treatment for GIO around the world, teriparatide was selected as one of alternative drugs of the first line agents for GIO in revised version of the guidelines on the management and treatment of GIO of the Japanese Society for Bone and Mineral Research：2014 update.