Stakkestad J A, Benevolenskaya L I, Stepan J J, Skag A, Nordby A, Oefjord E, Burdeska A, Jonkanski I, Mahoney P
CECOR AS, Haugesund, Norway.
Ann Rheum Dis. 2003 Oct;62(10):969-75. doi: 10.1136/ard.62.10.969.
To investigate the efficacy, safety, and dose response of three doses of ibandronate, given intermittently by intravenous (IV) injection every three months, in preventing postmenopausal osteoporosis.
629 postmenopausal women, categorised according to time since menopause and baseline lumbar spine (L1-4) bone mineral density (BMD), were enrolled into a multicentre, double blind, placebo controlled trial. They were randomly allocated to receive IV ibandronate 0.5 mg, 1 mg or 2 mg, or placebo every three months. All women received daily calcium supplementation.
One year's treatment with intermittent IV ibandronate injections produced a dose dependent gain in mean (SD) lumbar spine BMD from baseline of 2.5 (2.5)%, 1.8 (2.6)%, and 1.0 (2.8)% in the groups receiving 2 mg, 1 mg, and 0.5 mg ibandronate, respectively, compared with a loss of BMD of 0.4 (2.4)% in the women in the placebo group; p=0.0001 for each ibandronate dose v placebo. Highest BMD gains occurred in women with osteopenia receiving 2 mg ibandronate. Similarly, at the hip, all three doses of ibandronate produced significantly better gains in BMD than placebo (p<0.05), with the greatest gains in the women with osteopenia receiving the 2 mg dose. Ibandronate concomitantly and dose dependently suppressed markers of bone turnover in comparison with placebo, and injections were well tolerated.
IV ibandronate injections, given every three months, may be an effective alternative to oral bisphosphonates and hormonal therapy in the prevention of bone loss in postmenopausal women.
研究每三个月静脉注射(IV)一次三种剂量的伊班膦酸钠在预防绝经后骨质疏松症方面的疗效、安全性及剂量反应。
629名绝经后女性,根据绝经时间和基线腰椎(L1 - 4)骨密度(BMD)进行分类,纳入一项多中心、双盲、安慰剂对照试验。她们被随机分配,每三个月接受一次静脉注射0.5毫克、1毫克或2毫克伊班膦酸钠,或安慰剂。所有女性均每日补充钙。
与安慰剂组女性骨密度下降0.4(2.4)%相比,接受2毫克、1毫克和0.5毫克伊班膦酸钠治疗的组,经间歇性静脉注射伊班膦酸钠一年后,腰椎平均(标准差)骨密度从基线分别增加了2.5(2.5)%、1.8(2.6)%和1.0(2.8)%;各伊班膦酸钠剂量组与安慰剂组相比,p = 0.0001。接受2毫克伊班膦酸钠治疗的骨质减少女性骨密度增加最多。同样,在髋部,所有三种剂量的伊班膦酸钠在骨密度增加方面均显著优于安慰剂(p < 0.05),接受2毫克剂量的骨质减少女性增加最多。与安慰剂相比,伊班膦酸钠可同时并剂量依赖性地抑制骨转换标志物,且注射耐受性良好。
每三个月进行一次静脉注射伊班膦酸钠,在预防绝经后女性骨质流失方面可能是口服双膦酸盐和激素疗法的有效替代方法。