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Die Wirbelsäule 2020; 04(03): 219-238
DOI: 10.1055/a-0968-7097
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Osteoporose

Moderne Diagnostik und Therapie – Empfehlungen für den AlltagOsteoporosisModern Diagnostics and Therapy – Recommendations for Everyday Life
Andreas Kurth
,
Michael Rauschmann
,
Peyman Hadji
Subject Editor: Wissenschaftlich verantwortlich gemäß Zertifizierungsbestimmungen für diesen Beitrag ist Prof. Dr. med. Andreas Kurth, Koblenz.
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Zusammenfassung

Etwa 50 % der Frauen und 20 % der Mann ab 50 Jahren erleiden eine osteoporosebedingte Fraktur. Knochenbrüche im Alter sind die Ursache für ein erhöhtes Risiko für weitere Frakturen, eine erhöhte Sterblichkeit, zusätzliche Erkrankungen und Einschränkung der körperlichen Funktionen und dadurch reduzierte Lebensqualität und Verlust der Unabhängigkeit im täglichen Leben. Das übergeordnete Ziel der Diagnostik und Behandlung von Osteoporosepatienten besteht darin, Frakturen zu verhindern.

Abstract

Approximately one out of two women and 20 % of all men aged 50 years and more will suffer from an osteoporosis-related fracture. Broken bones in old age cause an increased risk of further fractures, an increased mortality, additional illnesses and reduced physical functions and thereby restriction of the quality of life and the loss of independence in daily life. More than half the patients suffer a subsequent fracture after the first one, which results in further hospital stays and operations. The primary goal of diagnosis and treatment of osteoporosis patients is to prevent the occurrence of fractures.

Fazit

Take Home Message

Bei Hochrisikopatienten mit einer osteoporotischen Fraktur sollte die nach neuester Evidenz die Therapie osteoanabole Substanzen (Terinparatid, Romosozumab) zum Einsatz kommen.

Kernaussagen

  • Die wichtigsten Formen der Osteoporose sind die postmenopausale, die sekundäre und die juvenile Osteoporose sowie die Osteoporose bei Männern.

  • Die Abnahme der Knochenmasse mit zunehmendem Alter ist ein physiologischer Vorgang. Übersteigt der Knochenmasseverlust jedoch das normale Ausmaß, entsteht eine Osteoporose.

  • Etwa jede zweite Frau und jeder fünfte Mann ab dem Alter von 50 Jahren erleidet eine osteoporosebedingte Fraktur.

  • Knochenbrüche im Alter sind die Ursache für ein erhöhtes Risiko für weitere Frakturen, eine erhöhte Sterblichkeit, zusätzliche Erkrankungen und Einschränkung der körperlichen Funktionen und dadurch Einschränkung der Lebensqualität und Verlust der Unabhängigkeit im täglichen Leben.

  • Mehr als die Hälfte der Patienten erleidet nach der ersten Fraktur eine Folgefraktur mit daraus resultierenden weiteren Krankenhausaufenthalten und Operationen.

  • Der Goldstandard für die quantitative Beurteilung von Knochenmineralstatus bei Erwachsenen ist die Duale Energie-Röntgenabsorptionsmessung (DXA), durchgeführt an der Lendenwirbelsäule und der Hüfte.

  • Die Medikamente zur Behandlung der postmenopausalen Osteoporose lassen sich unterteilen in

    • Antiresorptiva wie Bisphosphonate, Denosumab und selektive Östrogenrezeptor-Modulatoren (SERM) und

    • Osteoanabolika wie Teriparatid und Romosozumab.

  • Das übergeordnete Ziel der Diagnostik und Behandlung von Osteoporosepatienten besteht darin, das Auftreten von Frakturen zu verhindern.

Schlüsselwörter

Knochenqualität - Knochendichte - Lebensqualität - Fraktur - Knochenbruch

Keywords

fracture - broken bone - quality of life - bone density - bone quality


Publication History

Article published online:
13 August 2020

© Georg Thieme Verlag KG
Stuttgart · New York

 

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