在骨质疏松症中使用双酸盐药物假期根据骨折风险概况
Asunción Salmoral1, P Peris2, C López Medina3
1Department of Rheumatology, University Hospital Reina Sofía, Maimonides Institute for Biomedical Research of Córdoba (IMIBIC), University of Córdoba, Cordoba, Spain. asuncionsalmoral61@gmail.com.
概括
停止服用双酸盐会增加骨折的风险,特别是脊椎骨折,在第一年内. 由于这种风险增加,具有高风险概况的患者不应停止双酸盐治疗.
科学领域:
- 骨质疏松症管理管理
- 骨代谢研究研究 骨代谢研究
- 类风湿病学 类风湿病学
背景情况:
- 双酸盐治疗是骨质疏松症治疗的基石.
- 双酸盐治疗的最佳持续时间和停止治疗的安全性尚未得到充分确立.
- 在停止使用双酸盐后了解骨折发生率和骨密度变化对于临床实践至关重要.
研究的目的:
- 分析断裂发生率,危险因素,骨矿物质密度 (BMD) 和骨周转标记 (BTMs) 在停止服用双酸盐的患者中.
- 为了确定可能不会受益于停止双酸盐治疗的患者个人资料.
- 在现实临床环境中,评估在停止使用双酸盐后骨和骨的变化.
主要方法:
- 对264名患有骨质疏松症的患者进行了回顾性观察性研究,这些患者已停止服用双酸盐 (阿伦德罗纳特,瑞塞德罗纳特或佐勒德罗纳特).
- 数据收集包括骨折史,脊柱X射线,骨质量测量和停药前后的BTM.
- 根据基线特征,患者被分为高风险,中等风险和低风险的个人资料.
主要成果:
- 12.3%的患者在停止治疗后出现骨折,其中一半是临床脊椎骨折.
- 具有高风险的个人资料 (低部部T-score,骨折史) 与骨折发生率增加 (10.41%在12个月) 有显著的关联.
- 在部部和整个部发生了显著的BMD损失,受停药持续时间的影响;PINP在BTM中显示了最实质性的变化.
结论:
- 已经确定了患有骨折,特别是脊椎骨折高风险的特定患者概况.
- 这些高风险患者不应该停止双酸盐治疗,因为骨折的可能性很大,即使在停止治疗后的第一年内.
- 这些发现强调了在骨质疏松症管理中需要个性化治疗策略,以停止双酸盐治疗.
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