Nội dung được dịch bởi AI, chỉ mang tính chất tham khảo
Điều trị hướng đến mục tiêu trong bệnh loãng xương ở châu Âu
Tóm tắt
Mặc dù khả năng dự đoán của mật độ khoáng xương, Công cụ Đánh giá Rủi ro Gãy xương (FRAX®), các dấu ấn chuyển hóa xương và gãy xương đối với gãy xương do loãng xương đã được chứng minh, việc sử dụng chúng như những mục tiêu điều trị loãng xương vẫn còn hạn chế. Chiến lược điều trị theo mục tiêu là một phương pháp đã được áp dụng trong nhiều lĩnh vực y học và gần đây trở thành một lĩnh vực được quan tâm trong việc quản lý loãng xương. Vai trò của nó trong bối cảnh này vẫn còn gây tranh cãi. Bài báo này được chuẩn bị theo cuộc họp của nhóm làm việc thuộc Hiệp hội Châu Âu về các Khía cạnh Lâm sàng và Kinh tế của Loãng xương và Thoái hóa khớp (ESCEO) dưới sự bảo trợ của Quỹ Loãng xương Quốc tế (IOF) nhằm thảo luận về khả năng áp dụng một chiến lược như vậy trong loãng xương ở châu Âu. Các mục tiêu tiềm năng từ việc không có gãy xương xảy ra cho đến các mức mật độ khoáng xương (BMD) cố định, một điểm số FRAX® mong muốn, một mức độ dấu ấn chuyển hóa xương đã được xác định hoặc thực sự là sự thay đổi trong một hoặc sự kết hợp của các tham số này. Mặc dù tất cả những biến số này (đặc biệt là BMD và FRAX) đều có khả năng dự đoán gãy xương, việc sử dụng chúng như các mục tiêu vẫn bị hạn chế do độ nhạy thấp, ảnh hưởng của các yếu tố gây nhiễu và sự thiếu bằng chứng hiện tại cho thấy các mục tiêu có thể được đạt được một cách đồng nhất. ESCEO cho rằng hiện tại chưa khả thi để áp dụng chiến lược điều trị theo mục tiêu ở loãng xương, mặc dù họ đã xác định được nhu cầu tiếp tục cải thiện việc chỉ định điều trị cho những người có nguy cơ cao (chiến lược nhắm đến điều trị) và một số vấn đề cho chương trình nghiên cứu. Các vấn đề này bao gồm sự đồng thuận quốc tế về ngưỡng can thiệp và định nghĩa về thất bại điều trị, khám phá thêm mối quan hệ giữa gãy xương và BMD, cũng như sự hiệu quả của FRAX và điều trị cùng với việc nghiên cứu tiềm năng của các mục tiêu ngắn hạn để cải thiện sự tuân thủ.
Từ khóa
#loãng xương #mật độ khoáng xương #FRAX #điều trị theo mục tiêu #gãy xương #dấu ấn chuyển hóa xương #ESCEO #IOFTài liệu tham khảo
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