Desfechos clínicos do tratamento da osteoporose em homens: revisão da eficácia e segurança dos principais fármacos
DOI:
https://doi.org/10.34119/bjhrv8n4-151Keywords:
osteoporose masculina, tratamento farmacológico, densidade mineral óssea, eficácia terapêutica, segurança de medicamentosAbstract
A osteoporose em homens é uma condição clínica subdiagnosticada e subtratada, apesar do risco significativo de fraturas e morbimortalidade. Esta revisão narrativa teve como objetivo avaliar os desfechos clínicos, a eficácia e a segurança dos principais fármacos utilizados no tratamento da osteoporose masculina. Foram analisados ensaios clínicos, metanálises e estudos observacionais publicados entre 2000 e 2025, com ênfase em medicamentos como alendronato, risedronato, zoledronato, denosumabe, teriparatida, ibandronato, menatetrenona e eldecalcitol. Os resultados indicaram que esses fármacos são eficazes na melhora da densidade mineral óssea (DMO), com reduções significativas nos marcadores de remodelação óssea e taxas variáveis de fraturas. Teriparatida e denosumabe mostraram-se promissores em populações específicas, incluindo homens com comorbidades como diabetes tipo 2 e pacientes institucionalizados. Os bisfosfonatos continuam sendo uma primeira linha eficaz, especialmente em regimes de uso prolongado. Em relação à segurança, os efeitos adversos foram geralmente leves, embora haja necessidade de monitoramento específico, especialmente em idosos e indivíduos com risco renal. Conclui-se que há evidência consistente da eficácia dos principais agentes terapêuticos, sendo essencial uma abordagem individualizada para o manejo da osteoporose em homens.
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