抄録
Osteoporosis, a reduction in bone strength, is a disease of increased fracture risk, leading to enforced morbidity due to chronic pain and skeletal deformity and a consequent increase in mortality. Thus, a reduction of fracture risk is just a prerequisite, and decreases in morbidity and mortality are expected as further goals of osteoporosis treatment. Evidence has accumulated to indicate that treatments with amino-bisphosphonates and selective estrogen receptor modulators reduce fracture risk, maintain activities of daily living and quality of life, and decrease the death rate. The bone and joint destruction of rheumatoid arthritis is suspended by methotrexate and/or biological agents. The repair of bone erosion is obtained by drug therapy, but the repair of articular cartilage is difficult. Nonsteroidal anti-inflammatory drugs (NSAIDs) and intra-articular injection of hyaluronic acids and glucocorticoids are used for patients with osteoarthritis. However, there are currently no clinical interventions proven to restore cartilage and inhibit disease processes in osteoarthritis. The upper gastrointestinal tract injury associated with NSAIDs is a serious clinical problem. As a result, the use of COX-2 inhibitors and the use of oral NSAIDs with misoprostol or a proton pump inhibitor are recommended for gastroprotection. Also, the use of opioids and/or pregabalin is recommended as a further step in the treatment of chronic pain in bone and joint diseases.
