Therapeutisches Profil von Fluorid bei der Osteoporose

Zusammenfassung

Die Studiendaten zur Fluoridtherapie der Osteoporose erfüllen nicht die Kriterien der evidenz-basierten Medizin Kategorie A. Entsprechend umfangreiche randomisierte plazebokontrollierte Studien sind mit dem sehr preiswerten und nicht patentgeschützten Fluorid nie durchgeführt worden. Die starke osteoanabole Potenz der knochenspezifischen, oral anwendbaren Fluoridsalze steht jedoch außer Zweifel. Bei niedrigdosierten bzw. inter-mittierenden Therapieschemata resultiert ein kontinuierlicher, moderater Anstieg der Knochendichtewerte. Verschiedene Studien belegen die therapeutische Effizienz von Fluoriden bei der Frühtherapie und bei manifesten Osteoporosen, wobei in neueren Studien auch ein fraktursenkender Effekt dokumentiert werden konnte. Neue Perspektiven eröffnen sich durch eindeutig additive Effekte bei Kombination mit Kalzium/Vitamin D bzw. aktiven D-Analoga und anderen Antiresorptiva. Hier wären weitere Studien von großem Interesse.

Summary

Study results on fluoride treatment of osteoporosis do not reach the level A of evidence based medicine. Larger randomised placebo-controlled studies with sufficient power have never been performed with the very unex-pensive and not patent-protected fluoride salts. There is however no doubt about the strong anabolic potency of fluoride on bone metabolism. Continuous and moderate increases in bone mineral density can be achieved with low-dose or intermittent fluoride regimens. Numerous studies proved the therapeutic efficacy in early and established forms of osteoporosis and in several recent trials a significant reduction in vertebral fracture incidence could be proved. Additive effects were shown when fluoride was combined with calcium/vitamin D or active D-analogues or other antiresorptive substances. Further studies with combined regimens would be of high interests.

Schlüsselwörter

Osteoporose - Fluorid - anabole Therapie

Keywords

Osteoporosis - fluoride - anabolic treatment

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