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停用丹诺苏马布后的佐莱德罗纳特:重复注射是否比单次输液更有效?
Giorgia Grassi1, Alberto Ghielmetti2, Marta Zampogna2
1Endocrine Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.
在停止使用登苏马布后,连续使用佐莱德罗纳特治疗并没有防止高CTX水平的女性的骨密度下降或骨折. 需要进一步的研究来优化骨质疏松症管理的治疗策略.
科学领域:
- 内分泌学 在内分泌学.
- 骨质疏松症研究 骨质疏松症研究
- 药理干预药理干预
背景情况:
- 停止服用登苏马布会导致CTX增加,骨质量下降,以及潜在的骨折,影响妇女的健康.
- 建议进行连续的双酸盐治疗,但对于持续高的CTX水平,重复使用佐莱德酸盐 (ZOL) 的疗效尚不清楚.
研究的目的:
- 为了评估一系列治疗的有效性与两个zoledronate输注在预防骨矿物密度 (BMD) 损失和骨折后denosumab撤销的患者高CTX水平.
主要方法:
- 根据欧洲化组织学会 (ECTS) 的建议管理的52名患者的回顾性研究.
- 佐莱德罗纳特在德诺苏马布停药1个月后 (t0),如果CTX水平≥280 ng/L,在6个月后 (t1) 进行第二次输注.
- 大约17个月后评估的骨质量变化和骨折率.
主要成果:
- 75%的患者接受了第二次ZOL输液;这个群体经历了显著的脊柱BMD下降 (-5.5%).
- 在CTX<280 ng/L在t1 (-0.1%) 的患者中,脊柱BMD保持稳定.
- 在t1时CTX水平>212 ng/L预测了100%灵敏度的BMD损失;高CTX和先前的BMD增益与BMD恶化有关.
结论:
- 隔6个月的两次索莱德龙酸注射,在停止使用登苏马布后,在患有不受控制的CTX水平的患者中,不会防止BMD损失或骨折.
- 目前ECTS推的顺序治疗计划可能不足以管理后denosumab的骨循环标志物.
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