Sarioglu Mengu, Tuzun Cigdem, Unlu Zeliha, Tikiz Canan, Taneli Fatma, Uyanik B Sami
Department of Physical Medicine and Rehabilitation, Faculty of Medicine, University of Celal Bayar, 1748 sokak No. 26 Daire 4, 35530 Karsiyaka, Izmir, Turkey.
Rheumatol Int. 2006 Jan;26(3):195-200. doi: 10.1007/s00296-004-0544-z. Epub 2004 Dec 2.
The aim of the study was to compare the effects of once-weekly alendronate sodium and daily risedronate sodium treatment on bone mineral density (BMD) and bone turnover markers in postmenopausal osteoporotic subjects. For this purpose, 50 patients were included in this study and randomly classified into two groups. Group I (n=25) received risedronate (5 mg/day) and group II (n=25) received alendronate Na (70 mg/week). The study duration was limited to 12 months. The efficacy of the treatment was evaluated by BMD measurements at spine and hip at 6th and 12th months of the treatment, as well as by the measurement of bone turnover markers such as serum osteocalcin (OC), bone-specific alkaline phosphatase (BASP), urine deoxypyridinoline (DPD) and calcium/creatine ratio in 24-h urine at 1st, 3rd, 6th and 12th months. The evaluation of the changes in BMD in all regions revealed a significant increase in BMD in both groups compared to baseline values except for spine (L2-L4) in alendronate group at 6th and 12th month and femoral neck in risedronate group at 6th month. However, the difference in percentage increase in BMD measurements was not statistically significant between the two groups at 6th and 12th months. In both groups, serum OC, BSAP and urine DPD were found to be significantly attenuated at 1st month of the treatment period, and continued to be lowered throughout the 3rd, 6th and 12th months (P<0.05). However, there was no statistically-significant difference between both groups of patients (P>0.05). In conclusion, our results suggest that both treatment protocols provide treatment options of similar efficiency for postmenopausal osteoporosis, and have almost-similar effects in enhancing the BMD and in slowing the bone turnover. Risedronate seems to have a more potent effect in the spinal region than that of alendronate, although this potency was not statistically significant.
本研究的目的是比较每周一次阿仑膦酸钠和每日一次利塞膦酸钠治疗对绝经后骨质疏松症患者骨密度（BMD）和骨转换标志物的影响。为此，本研究纳入了50例患者，并将其随机分为两组。第一组（n = 25）接受利塞膦酸钠（5毫克/天），第二组（n = 25）接受阿仑膦酸钠（70毫克/周）。研究持续时间限制为12个月。通过在治疗的第6个月和第12个月测量脊柱和髋部的骨密度，以及在第1、3、6和12个月测量骨转换标志物，如血清骨钙素（OC）、骨特异性碱性磷酸酶（BASP）、尿脱氧吡啶啉（DPD）和24小时尿钙/肌酐比值，来评估治疗效果。对所有区域骨密度变化的评估显示，与基线值相比，两组的骨密度均显著增加，但阿仑膦酸钠组在第6个月和第12个月时脊柱（L2 - L4）以及利塞膦酸钠组在第6个月时股骨颈除外。然而，在第6个月和第12个月时，两组骨密度测量增加百分比的差异无统计学意义。在两组中，治疗第1个月时血清OC、BSAP和尿DPD均显著降低，并在第3、6和12个月持续降低（P<0.05）。然而，两组患者之间无统计学显著差异（P>0.05）。总之，我们的结果表明，两种治疗方案为绝经后骨质疏松症提供了效率相似的治疗选择，在提高骨密度和减缓骨转换方面具有几乎相似的效果。利塞膦酸钠在脊柱区域似乎比阿仑膦酸钠具有更强的作用，尽管这种强度无统计学意义。
