特立帕肽治疗骨质疏松性骨折中国专家共识(2024版)

Chinese expert consensus on treatment of osteoporotic fractures with teriparatide (2024 edition)

骨质疏松性骨折是骨质疏松最严重的并发症,是骨骼在骨质疏松病变的基础上发生的一种特殊类型的病理性骨折,具有愈合困难、再骨折风险高、致残致死率高、治疗难度大、治疗时间长的特点,且再骨折具有“级联效应”。各国指南建议,骨质疏松性骨折患者和极高危骨折风险患者应首先考虑促成骨治疗。特立帕肽是中国目前唯一已被批准应用于临床的促成骨类药物,在治疗骨质疏松性骨折时具有促进骨折愈合、降低再骨折风险、改善骨微结构等临床疗效。针对目前特立帕肽临床使用标准与规范的不足,由中国康复技术转化与发展促进会骨质疏松性骨折加速康复专业委员会、中华医学会骨质疏松和骨矿盐疾病委员会骨与关节学组以及中国医师协会骨科医师分会骨质疏松工作委员会联合组织相关学科专家起草制订本共识。本共识制订遵循改良Delphi法,形成8条循证医学推荐意见,旨在提出科学规范应用特立帕肽的方法和注意事项,强调特立帕肽应用对于骨质疏松性骨折患者治疗的重要性。

Osteoporotic fracture is the most serious complication of osteoporosis,which is a special type of pathologic fracture of the skeleton that occurs because of osteoporosis.It is characterized by delayed fracture healing,high risk of re-fracture,high rate of disability and death,difficulty in treatment and long treatment time,and re-fracture has a"cascade effect".Guidelines in different countries recommend that patients with osteoporotic fractures and those at very high risk of fracture should consider anabolic agents as first treatment choice.Teriparatide is the only anabolic agent approved by National Medical Products Administration(NMPA),and it has the clinical efficacy of improving fracture healing,reducing the risk of re-fracture,and improving bone microstructure in the treatment of osteoporotic fracture.Due to deficiencies in the current standardization of clinical use of teriparatide,Committee of Accelerated Rehabilitation After Osteoporotic Fractures of China Association of Rehabilitation Technology Transformation and Promotion,Bone and Joint Group of Chinese Society of Osteoporosis and Bone Mineral Research and Osteoporosis Working Committee of Chinese Association of Orthopedic Surgeons developed this consensus.The development of this consensus follows the modified Delphi method and forms 8 evidence-based medical recommendations,aiming to propose methods and precautions for standardizing the application of teriparatide,and to emphasize the importance of teriparatide application for the treatment of patients with osteoporotic fracture.