一个对比2年后的denosumab的alendronate:卡的延长
Joy N Tsai1, Mackenzie Jordan2, Hang Lee3
1Department of Medicine, Endocrine Unit, Massachusetts General Hospital, Harvard University, Boston, MA, USA. jntsai@mgh.harvard.edu.
概括
discontinuing denosumab 需要抗吸收疗法,以防止骨质损失. 这项研究发现,经过一年的德诺苏马布治疗,一到两年的阿伦德罗纳酸有效地维持了骨密度的增加.
科学领域:
- 内分泌学 在内分泌学.
- 骨的新陈代谢 骨的新陈代谢
- 药理学 药理学是指药理学的学科.
背景情况:
- 停止使用登苏马布可以导致由于骨周转率增加而导致快速骨质流失.
- 代诺苏马布后的最佳抗吸收疗法持续时间尚未确定.
- 之前的研究表明,在维护denosumab诱导的骨矿物质密度 (BMD) 增加方面,阿伦德罗纳特优于拉洛西芬.
研究的目的:
- 评估12个月的阿伦德罗纳酸是否足以维持12个月的迪诺苏马布获得的BMD增长.
- 评估延长的阿伦德罗纳特疗法 (总共24个月) 与单独的和维生素D在停用德诺苏马布后的疗效.
主要方法:
- 一个随机对照试验扩展,涉及60-79岁的绝经后妇女,骨折风险高.
- 参与者接受了12个月的登苏马布,然后12个月的阿伦德罗纳酸或拉洛西芬.
- 阿伦德罗纳特组进一步随机分配,继续服用阿伦德罗纳特12个月或仅接受/维生素D.
主要成果:
- 与基线相比,12个月和24个月的阿伦德罗纳特都维持了脊椎,部和大腿部的BMD.
- 在/维生素D组,在整个部和大腿部部观察到骨质量暂时下降.
- 骨周转率标志物在两组中都保持低于基线的抑制,而/维生素D组的水平趋向于更高.
结论:
- 一到两年的阿伦德罗纳酸有效地保留了经过一年的德诺苏马布后的BMD增长.
- 德诺苏马布之后的阿伦德罗纳特治疗可以防止骨循环标记的反弹.
- 这项研究提供了指导临床决策的证据,以确定后代诺苏马布治疗的持续时间.
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