ビスホスホネート製剤と非定型大腿骨骨折

An update on bisphosphonates and trends in drug therapy for osteoporosis. Atypical femoral fracture and Bisphosphonate.

　骨粗鬆症診療におけるビスホスホネート製剤の普及とともに非定型大腿骨骨折が合併症として報告され，骨代謝回転の過剰抑制がその原因として注目された。本骨折の発症には様々な要因が関与しており，ビスホスホネート治療における骨組織のミクロからマクロの形態および代謝変化とともに多面的に検証することで，病態の解明と本骨折の治療および予防が可能となる。

　Bisphosphonate therapy had been spread widely in osteoporosis patients, atypical femoral fractures（AFF）were reported in these patients as the unusual effects of bisphosphonate treatment. The pathogenesis of AFF was considered to be an over suppression of bone turnover by bisphosphonate. However recent studies indicated other factors related to AFF initiation. Further studies are required to clarify the mechanism of AFF in order to resolve this adverse events in osteoporosis clinic.