重视骨质疏松症达标治疗的临床意义OA

As the number of osteoporosis patients continues to increase,treatment strategies tend to be individu-alized and long-term management.Treat-to-target therapy is a chronic disease management strategy that sets clear treatment goals,optimizes plans,and regularly evaluates and adjusts them.This approach promotes personalized treatment and en-hances patient engagement.Treat-to-target therapy has been applied in the management of various chronic diseases.Since the concept of treat-to-target therapy for osteoporosis was proposed in 2013,its application has been limited due to the lack of unified target standards,equipment limitations,limited drug choices,and low patient compliance.In recent years,with advances in diagnostic technology and the application of new drugs,treat-to-target therapy has gradually been recognized by international authoritative organizations.Bone mineral density(BMD)T-score is recommended as the preferred quanti-tative target for treat-to-target therapy of osteoporosis.Based on the patient's baseline BMD,fracture history,and risk fac-tors,individualized post-treatment target T-scores are set.For patients with a baseline T-score≤-2.5,the recommended post-treatment target is a T-score＞-2.5;for patients with a baseline T-score≤-2.5 combined with recent fracture his-tory,recent fall history,advanced age,or poor physical function,a higher post-treatment target T-score is recommended;for patients with a baseline T-score＞-2.5 and fragility fractures,the recommended post-treatment target is to increase the T-score,with a total hip T-score increase of 0.2 and a lumbar spine T-score increase of 0.5.In terms of drug selection,therapeutic drugs should be chosen based on fracture history,BMD,and fracture site,with osteoanabolicagentsbeing the first choice for patients with extremely low BMD or recent fractures.During the treatment,BMD and bone turnover markers should be regularly monitored,patients'compliance should be assessed,and maintenance therapy or drug holidays should be considered after reaching the treatment target.For patients who have not reached the treatment target,treatment plan should be adjusted or intensified.