Nakamura Tomoko, Maekawa Soichiro, Morinobu Sahoko, Morinobu Akio, Koshiba Masahiro, Yamauchi Mika, Sugimoto Toshitsugu, Kumagai Shunichi
Ryumachi. 2002 Aug;42(4):666-75.
To compare the bone-mass effects of intermittent cyclic etidronate administration in patients of various rheumatic disease patients with corticosteroid-induced osteoporosis.
We evaluated bone mineral density (BMD) of lumbar spine in 34 female patients (mean age: 46.4 +/- 13.7 y. o. 17-71) treated with long term corticosteroid (> 6 months). Eighteen patients cyclically received etidronate orally (400 mg or 200 mg etidronate daily for 2 weeks, followed by 10-12 weeks drug-free periods). Twelve in these 18 patients received 400 mg (group A) and another 6 patients were treated with 200 mg/day (group B). Sixteen patients free from etidronate administrations were analysed as a control group.
Cyclical etidronate therapy showed significant increase in BMD. The BMD of lumbar spine increased from 0.760 +/- 0.10 g/cm 2 to 0.783 +/- 0.11 g/cm 2 (%change from baseline 2.91 +/- 2.56%/year) in group A treated patients after 12 months. Reduced BMD (%change from baseline 1.55 +/- 2.48%) was observed in 16 control group patients (P < 0.0012). The BMD in group A was significantly high compared to group B or control after the etidronate treatment. In 7 of group A, BMD increased significantly on 6 months but no more significant increase was shown on 12 months compared to the value on 6 months. On the other hand the BMD tend to increased for after 2 years in intermittent cyclic etidronate treatment in 8 cases of group A. There were no adverse effects and abnormal laboratory data related to the administration of etidronate. Although only 2 cases of group A showed the findings of compression fracture before the study, but no new compression fracture appeared in any group during this study.
It was shown that cyclical etidronate therapy is effective for steroid induced osteoporosis.
比较间歇性周期性服用依替膦酸对各类风湿性疾病伴皮质类固醇诱导性骨质疏松症患者骨量的影响。
我们评估了34名长期(>6个月)接受皮质类固醇治疗的女性患者(平均年龄:46.4±13.7岁,年龄范围17 - 71岁)腰椎的骨矿物质密度(BMD)。18名患者周期性口服依替膦酸(每日400毫克或200毫克依替膦酸,服用2周,随后为10 - 12周的无药期)。这18名患者中,12名接受400毫克治疗(A组),另外6名患者接受每日200毫克治疗(B组)。16名未接受依替膦酸治疗的患者作为对照组进行分析。
周期性依替膦酸治疗显示骨密度显著增加。A组接受治疗的患者在12个月后,腰椎骨密度从0.760±0.10克/平方厘米增加到0.783±0.11克/平方厘米(相对于基线的变化率为2.91±2.56%/年)。16名对照组患者骨密度降低(相对于基线的变化率为1.55±2.48%)(P<0.0012)。依替膦酸治疗后,A组的骨密度显著高于B组或对照组。A组中有7名患者在6个月时骨密度显著增加,但与6个月时的值相比,12个月时未显示出更显著的增加。另一方面,A组中有8例患者在间歇性周期性依替膦酸治疗2年后骨密度有增加趋势。未出现与依替膦酸给药相关的不良反应和异常实验室数据。尽管A组在研究前只有2例显示有压缩性骨折的表现,但在本研究期间任何组均未出现新的压缩性骨折。
结果表明,周期性依替膦酸治疗对类固醇诱导的骨质疏松症有效。