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01-10-2008 | Artikel

Behandeling van osteoporose bij ouderen: wat is de evidence?

Auteur: Dr. H. J. J. Verhaar

Gepubliceerd in: Tijdschrift voor Gerontologie en Geriatrie | Uitgave 5/2008

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Samenvatting

Veel ouderen, vooral vrouwen, en hun artsen zien osteoporose nog steeds als een natuurlijk onderdeel van het ouder worden, in plaats van een te voorkomen of behandelbare medische aandoening. Hoogteverlies, hyperkyfose, rugpijn en fracturen worden geaccepteerd als een gevolg van het ouder worden. Een andere barrière voor het instellen van een behandeling is het idee dat het te laat is om daarmee te beginnen in een laat stadium van de ziekte. Hoewel de meeste onderzoeken naar fractuurreductie met medicatie niet waren ontworpen voor de ‘geriatrische’ populatie, was de gemiddelde leeftijd van de deelnemers aan de meeste klinische trials wel rond de 70 jaar. In alle grote onderzoeken kregen patiënten ook steeds calcium- en vitamine-D-suppletie. Uit de beschreven vergelijking van farmacologische opties blijkt dat de arts tegenwoordig de keuze heeft uit meerdere, bewezen effectieve middelen ter preventie van osteoporotische fracturen bij postmenopauzale vrouwen met een verhoogd fractuurrisico. Er zijn nu antifractuurgegevens bekend van calcium/vitamine D, raloxifene, bisfosfonaten, strontiumranelaat en parathormoon. Bisfosfonaten en strontiumranelaat zijn beide goede keuzes voor eerstelijns- of tweedelijnsbehandeling, terwijl parathormoon vooralsnog alleen als tweedelijnsbehandeling van osteoporose bij ouderen kan worden ingezet.
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Metagegevens
Titel
Behandeling van osteoporose bij ouderen: wat is de evidence?
Auteur
Dr. H. J. J. Verhaar
Publicatiedatum
01-10-2008
Uitgeverij
Bohn Stafleu van Loghum
Gepubliceerd in
Tijdschrift voor Gerontologie en Geriatrie / Uitgave 5/2008
Print ISSN: 0167-9228
Elektronisch ISSN: 1875-6832
DOI
https://doi.org/10.1007/BF03078150