閉経後の骨粗鬆症におけるデノスマブとテリパラチドの移行 (DATA-Switch研究):ランダム化制御試験の延長
Benjamin Z Leder1, Joy N Tsai1, Alexander V Uihlein1
1Department of Medicine, Endocrine Unit, Massachusetts General Hospital, Boston, MA, USA.
Lancet (London, England)
|July 7, 2015
まとめ
骨粗鬆症の患者をテリパラチドからデノスマブに切り替えると,骨のミネラル密度の増加が維持されました. 対照的に,デノスマブからテリパラチドに切り替えると,骨の減少が起こり,骨粗鬆症の治療戦略に影響を与えました.
科学分野:
- エンドクリノロジー エンドクリノロジー
- 骨の生物学 骨の生物学
- 薬理学 薬理学とは
背景:
- 骨粗鬆症の治療には,しばしば単一の薬物が含まれており,骨格の完全性を回復する効果は限られている.
- 連続的な薬物使用は一般的ですが,最適な切り替え戦略は不明です.
- 以前の研究では,テリパラチドとデノスマブを併用すると,骨のミネラル密度 (BMD) が増加することが示されました.
研究 の 目的:
- テリパラチドとデノスマブ療法の間で移行している閉経後の骨粗鬆症の女性におけるBMDの変化を評価するために.
- 骨密度とターンオーバーマーカーの異なる薬物交換配列の有効性を比較する.
主な方法:
- ランダム化対照試験 (DATA-Switch) が,DATA研究を拡張しました.
- 94人の閉経後の女性は,24ヶ月間,テリパラチド,デノスマブ,またはその両方を受けた.
- その後,参加者はデノスマブ単独投与,テリパラチド単独投与,またはデノスマブ投与を継続し,48ヶ月間にわたってBMDを測定しました.
主要な成果:
- テリパラチドからデノスマブに切り替えると,BMDの増加が維持された.
- デノスマブからテリパラチドに切り替えると,進行的または一時的な骨の喪失が起こりました.
- 併用療法グループは,総股関節と股関節頸部BMDの最大の増加を示しました.
結論:
- テリパラチドからデノスマブに切り替えることは,BMDの維持に効果的です.
- デノスマブからテリパラタイドに切り替えると,骨の衰えが起こり,慎重に治療計画を立てる必要があります.
- 治療順序は,閉経後の骨粗鬆症における骨密度結果に大きく影響します.
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