如何权衡二膦酸盐类药物治疗骨质疏松症的利与弊？

Benefits and risks of bisphosphonate therapy for osteoporosis

二膦酸盐能有效减少绝经后妇女以及男性骨质疏松患者的骨量丢失，降低骨折风险。但有报道此类药物可能引起下颌骨坏死和非典型股骨骨折等严重并发症，总体发生率极低。口服二膦酸盐可能引起上消化道不良反应，静脉二膦酸盐与急性期反应相关。至于其是否会增加食道癌和心房纤颤的风险，目前尚缺乏有效证据。

Bisphosphonates have been efficacious in preventing bone loss and reducing fractures in men and postmenopausal women with osteoporosis. Possible risks of osteonecrosis of the jaw and atypical femur fractures have been reported with bisphosphonates treatment, despite these incidences are very low. Oral bisphosphonates are associated with upper gastrointestinal side effects and iv bisphosphonates with acute phase reactions, the association of bisphosphonate use with esophageal cancer and atrial fibrillation is not well supported by current data.