Dane Cem, Dane Banu, Cetin Ahmet, Erginbas Murat
Department of Gynecology and Obstetrics, Haseki Training and Research Hospital, Istanbul, Turkey.
Gynecol Endocrinol. 2008 Apr;24(4):207-13. doi: 10.1080/09513590801895617.
The primary objective of the present study was to evaluate the effectiveness and adverse events of risedronate use in postmenopausal woman by measuring its effects on urinary crosslinked C-terminal telopeptides of type I collagen (CTx), a biochemical marker of bone resorption.
One hundred osteoporotic (control and treatment) and 111 osteopenic (control and treatment) postmenopausal women, selected according to World Health Organization criteria, were included in the study. The treatment groups (osteopenic and osteoporotic) were given risedronate 35 mg once a week. The primary endpoint was mean percentage change in CTx from baseline to 6 months. The secondary endpoints included evaluation of the incidence of clinical or laboratory adverse events occurring during the 6-month study period. The least significant change (LSC), calculated from the within-subject variability in the two control groups, was used to define response.
Of the 211 women enrolled, 157 (74.4%) completed the study. After 6 months, urinary CTx levels were -54.7% (range -67% to -48%) below baseline in the osteoporotic treatment group and -66.7% (range -74% to -59%) below baseline in the osteopenic treatment group. Analysis of LSC showed that 89% of risedronate treatment groups were categorized as responders after 6 months of treatment.
The study shows that osteoporotic and osteopenic women on risedronate treatment have statistically significant suppressed bone turnover and CTx can be useful to confirm this observation. The low withdrawal rate and adverse effects rate show that risedronate was well tolerated by the study population.
本研究的主要目的是通过测量利塞膦酸盐对I型胶原交联C末端肽(CTx,一种骨吸收的生化标志物)的影响,评估其在绝经后女性中的有效性和不良事件。
根据世界卫生组织标准选择了100名骨质疏松症(对照组和治疗组)和111名骨质减少症(对照组和治疗组)的绝经后女性纳入研究。治疗组(骨质减少症组和骨质疏松症组)每周一次给予35mg利塞膦酸盐。主要终点是从基线到6个月时CTx的平均百分比变化。次要终点包括评估6个月研究期间发生的临床或实验室不良事件的发生率。根据两个对照组的受试者内变异性计算出的最小显著变化(LSC)用于定义反应。
在纳入的211名女性中,157名(74.4%)完成了研究。6个月后,骨质疏松症治疗组的尿CTx水平比基线低54.7%(范围为-67%至-48%),骨质减少症治疗组的尿CTx水平比基线低66.7%(范围为-74%至-59%)。LSC分析显示,治疗6个月后,89%的利塞膦酸盐治疗组被归类为反应者。
该研究表明,接受利塞膦酸盐治疗的骨质疏松症和骨质减少症女性的骨转换受到统计学上显著的抑制,CTx可用于证实这一观察结果。低退出率和不良反应率表明研究人群对利塞膦酸盐耐受性良好。