治疗持久性和药物切换与骨质疏松性骨折后后续骨折相关
Sung-Yen Lin1,2,3,4,5, Wei-Ju Chen6, Chieh-Ko Ku6
1Orthopaedic Research Center, Kaohsiung Medical University, Kaohsiung 80708, Taiwan.
The Journal of clinical endocrinology and metabolism
|August 1, 2023
概括
保持一致的抗骨质疏松药物 (AOM) 使用,即使切换,也会降低骨折风险. 不持久的AOM显著增加了部,脊椎和半径骨折的风险.
科学领域:
- 骨质疏松症的管理和骨折的预防.
- 对骨健康的药理干预措施.
背景情况:
- 切换抗骨质疏松症药物 (AOM) 在现实实践中很常见.
- 有限的数据存在于持续的AOM治疗,包括切换,对随后的骨折风险的影响.
研究的目的:
- 检查骨质疏松性骨折患者中AOM持久性和随后骨折之间的关联,允许药物切换.
- 评估AOM功率切换对骨折风险的影响.
主要方法:
- 使用台湾国家医疗保险索赔数据 (2013-2016) 的回顾性队列研究.
- 确定的治疗持续时间与45天的宽限期;允许药物切换.
- 分类AOMs作为高强度 (zoledronate,denosumab) 或低强度.
- 使用多变量考克斯模型来评估骨折风险.
主要成果:
- 包括119,473名患者;26.8%的AOM转换;52%在1年内持久.
- 与持续使用者相比,非持久性AOM使用者患部 (aHR=1.31),脊椎 (aHR=1.17) 和半径 (aHR=1.16) 骨折的风险更高.
- 从高强度AOM切换到低强度AOM增加了脊椎骨折风险 (aHR=1.28) 与没有强度切换.
结论:
- 不持续使用AOM与随后骨折的风险更高有关,即使允许切换药物.
- 切换AOM强度可能会影响脊椎骨折风险,需要进一步研究.
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