由于延迟注射德诺苏马布而遭受多次自发脊椎骨折的绝经后女性的脊柱骨质恶化 - 一个基于骨活检的治疗后重新开始的病例研究
Louise Alstrup Drejer1, Bilal Mohamad El-Masri2,3,4, Charlotte Ejersted5
1Department of Endocrinology, University Hospital of Southern Denmark, Esbjerg, Denmark.
Bone reports
|August 14, 2023
概括
停止治疗骨质疏松症的德诺苏马布可能会导致严重的脊椎骨折,原因是骨质流失和矿物质化受损. 在停止这种强效抗吸收药物时,谨慎的管理策略至关重要.
科学领域:
- 骨生物学和新陈代谢
- 药理学和治疗学 药理学和治疗学
背景情况:
- 德诺苏马布是骨质疏松症的有效抗吸收剂,增加骨矿物质密度并降低骨折风险.
- 然而,突然停止使用德诺苏马布与反弹骨复吸和骨折发生率增加有关,特别是脊椎骨折.
研究的目的:
- 为了研究骨微观结构和矿物化在停止和重新启动denosumab后.
- 在延迟注射denosumab后经历多个脊椎骨折的患者中分析组织形态变化.
主要方法:
- 一个64岁的女性患有绝经后骨质疏松症,接受了denosumab治疗的病例报告.
- 在重新开始治疗后,使用微计算机断层扫描和组织形态测量分析阴茎骨活检.
- 评估椎骨体积,厚度,间距,数量和结构模型指数.
主要成果:
- 微型CT显示了低椎骨体积,薄化和板块损失.
- 基质形态测量显示骨的大量再吸收和延迟矿化,其中高百分比的未矿化骨质.
- 矿化滞后时间显著延长,表明骨形成受损.
结论:
- 停止使用登苏马布可以导致显著的骨再吸收和受损的矿化在重新启动.
- 这一案例凸显了对代诺苏马布治疗的优化停药策略的需要.
- 需要进一步的研究,以了解和管理与退出denosumab相关的风险.
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