geriatrРоссийский журнал гериатрической медициныRussian Journal of Geriatric Medicine2686-86362686-8709Сайт издателя10.37586/2686-8636-2-2025-115-124geriatr-503Research ArticleОБЗОРЫREVIEWSСовременные подходы к фармакотерапии остеопороза в гериатрической практике: обзор литературыPharmacological Management of Osteoporosis in Geriatric Populations: A Comprehensive Literature Reviewhttps://orcid.org/0000-0001-7891-6850ДудинскаяЕ. Н.DudinskayaE. N.

Москва

Moscow

dudinskaya_en@rgnkc.ruhttps://orcid.org/0000-0002-1216-0787БраиловаН. В.BrailovaN. V.

Москва

Moscow

https://orcid.org/0000-0002-4193-688XТкачеваО. Н.TkachevaO. N.

Москва

Moscow

ФГАОУ ВО РНИМУ им. Н. И. Пирогова Минздрава России (Пироговский Университет), ОСП «Российский геронтологический научно-клинический центр»РоссияRussian Gerontology Research and Clinical Centre, Pirogov National Research Medical UniversityRussian Federation20250505202502115124Copyright © Дудинская Е.Н., Браилова Н.В., Ткачева О.Н., 20252025Дудинская Е.Н., Браилова Н.В., Ткачева О.Н.Dudinskaya E.N., Brailova N.V., Tkacheva O.N.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.geriatr-news.com/jour/article/view/503

Остеопороз представляет собой системное метаболическое заболевание скелета, характеризующееся прогрессирующим снижением минеральной плотности костной ткани (МПК) и нарушением ее микроархитектоники, что приводит к повышению хрупкости костей и увеличению риска низкоэнергетических переломов. Особую актуальность данная патология приобретает в гериатрической практике, где ее распространенность достигает критических показателей. Согласно эпидемиологическим данным, среди лиц старше 65 лет остеопороз диагностируется у каждой третьей женщины и каждого пятого мужчины, что обусловливает его значимую медико-социальную нагрузку. Клиническая значимость остеопороза определяется его тяжелыми осложнениями: хроническим болевым синдромом, выраженным ограничением подвижности, снижением качества жизни, а также повышением риска инвалидизации и летальности (особенно после переломов проксимального отдела бедра). В этой связи разработка эффективных стратегий лечения и профилактики остеопороза у пациентов пожилого и старческого возраста представляет одну из приоритетных задач современной геронтологии и остеологии. Современные подходы к фармакотерапии остеопороза включают применение антирезорбтивных (бисфосфонаты, деносумаб) и анаболических (терипаратид, ромосозумаб) препаратов, выбор которых требует учета возрастных особенностей пациентов, коморбидного фона и индивидуального риска переломов. В настоящем обзоре систематизированы актуальные данные о возможностях медикаментозной коррекции остеопороза в гериатрической практике, включая новые терапевтические подходы и перспективные направления лечения.

Osteoporosis is a systemic metabolic bone disease characterized by progressive loss of bone mineral density (BMD) and deterioration of bone microarchitecture, leading to increased bone fragility and susceptibility to low-energy fractures. This condition is of particular concern in geriatric populations, where its prevalence reaches critical levels. Epidemiological studies indicate that osteoporosis affects one in three women and one in five men over 65 years of age, representing a significant medical and socioeconomic burden. The clinical significance of osteoporosis stems from its severe complications, including chronic pain syndrome, profound mobility limitations, reduced quality of life, and increased risks of disability and mortality (particularly following hip fractures). Consequently, developing effective treatment and prevention strategies for osteoporosis in elderly and senile patients remains a priority in modern gerontology and osteology. Contemporary pharmacological approaches to osteoporosis management include antiresorptive (bisphosphonates, denosumab) and anabolic (teriparatide, romosozumab) agents, with treatment selection requiring careful consideration of age-related factors, comorbidities, and individual fracture risk profiles. This review synthesizes current evidence on pharmacological interventions for osteoporosis in geriatric practice, including emerging therapeutic strategies and future treatment directions.

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The authors declare that there are no conflicts of interest present.