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Arthritis und Rheuma 2021; 41(01): 31-35
DOI: 10.1055/a-1365-0418
Schwerpunkt

Aspekte der medikamentösen Therapie der Osteoporose bei rheumatoider Arthritis

Aspects of drug therapy for osteoporosis in rheumatoid arthritis
Björn Bühring∗
1   Rheumazentrum Ruhrgebiet, Ruhr-Universität Bochum
,
Friederike Thomasius∗
2   Frankfurter Hormon und Osteoporosezentrum
,
Uwe Maus∗
3   Universitätsklinikum Düsseldorf, Klinik für Orthopädie und Unfallchirurgie
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ZUSAMMENFASSUNG

Entzündlich rheumatische Erkrankungen wie die rheumatoide Arthritis, die ankylosierende Spondylitis und der systemische Lupus erythematodes führen zu einem erhöhten Risiko für eine Osteoporose und osteoporotische Frakturen. Das Risiko wird durch die Krankheitsaktivität, die körperlichen Einschränkungen, die medikamentöse Therapie und den Einsatz von Glukokortikoiden wesentlich beeinflusst. Eine möglichst frühe Therapie mit einer effektiven Kontrolle der Entzündungsaktivität ist daher zur Verminderung des Frakturrisikos wesentlich. Die Gabe von Glukokortikoiden sollte soweit möglich reduziert werden. Das Risiko für eine Osteoporose sollte durch eine möglichst frühzeitige Diagnostik analysiert und bei entsprechender Indikation eine osteologische Medikation eingeleitet werden. Die Wahl des Medikamentes erfolgt auf der Basis des jeweiligen Risikos und der jeweiligen Indikation. Die Grundlage jeder Osteoporosetherapie ist eine ausreichende Zufuhr von Vitamin D und Kalzium und eine angepasste körperliche Aktivität.

SUMMARY

Inflammatory rheumatic diseases such as rheumatoid arthritis, ankylosing spondylitis and systemic lupus erythematosus, lead to an increased risk of osteoporosis and osteoporotic fractures. The risk is significantly influenced by disease activity, physical limitations, drug therapy and the use of glucocorticoids. Therapy as early as possible with effective control of inflammatory activity is therefore essential to reduce the risk of osteoporosis. The administration of glucocorticoids should be reduced or avoided as far as possible. The risk of osteoporosis should be detected early and, if indicated, osteoporotic medication should be initiated. The choice of medication is made on the basis of the respective risk and indication. The foundation of every osteoporosis therapy is a sufficient intake of vitamin D and calcium and adapted physical activity.

Schlüsselwörter

Osteoporose - rheumatoide Arthritis - osteoporotische Fraktur - Glukokortikoide - Bisphosphonat

Keywords

Osteoporosis - rheumatoid arthritis - osteoporotic fracture - glucocorticoids - bisphosphonate


Publication History

Article published online:
26 February 2021

© 2021. Thieme. All rights reserved.

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