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激素替代和阿伦德罗纳酸的联合疗法用于预防老年妇女的骨质损失:一项随机对照试验
Susan L Greenspan1, Neil M Resnick, Robert A Parker
1Division of Endocrinology and Metabolism and Division of Geriatric Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pa, USA. griffithsd@msx.dept-med.pitt.edu
JAMA
|May 22, 2003
概括
使用激素替代和阿伦德罗纳酸的联合治疗显著改善了老年妇女的骨矿物质密度. 这种组合方法在骨质疏松症治疗中被证明优于单一疗法,并且耐受性良好.
科学领域:
- 老年学是一门学科.
- 药理学 药理学是指药理学的学科.
- 骨的新陈代谢 骨的新陈代谢
背景情况:
- 绝经后骨质疏松症的管理通常涉及抗吸收剂.
- 在老年妇女中,将激素替代疗法 (HRT) 与像阿伦德罗纳特这样的双酸盐相结合的疗效和安全性尚未得到充分证实.
- 在这个人口群体中,组合治疗与单一治疗的比较有效性仍然是未知的.
研究的目的:
- 评估联合HRT和阿伦德罗纳酸治疗的疗效和安全性.
- 在社区居住的老年妇女中,比较组合治疗与单一治疗的效果.
主要方法:
- 一个随机,双盲,安慰剂对照试验,涉及373名65岁及以上的妇女.
- 参与者接受了HRT (带有或没有medroxyprogesterone的结合性马雌激素) 和alendronate (每天10毫克) 或安慰剂的2x2因子设计,以及和维生素D补充剂.
- 在3年内评估了部和脊柱的骨矿物质密度变化和不良事件.
主要成果:
- 与单一治疗相比,组合疗法在所有测量的部和脊椎部位产生了显著更大的骨矿物质密度增加.
- 阿伦德罗纳特单独治疗显示出比HRT单独治疗更大的疗效,有更多的响应者.
- 所有治疗方案都被很好地容忍,参与者在3年后的保留率为90%.
结论:
- 联合HRT和alendronate疗法是有效和安全的治疗更年期后的老年妇女的骨质疏松症.
- 阿伦德罗纳特证明优于HRT,组合疗法超过单独使用的任何药物.
- 组合疗法为严重的骨质疏松症或耐治疗病例提供了有效的选择.
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