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利塞膦酸盐在患有炎症性肠病的绝经后骨质疏松症女性中的疗效:一项前瞻性、平行、开放标签的两年期扩展研究。

Effectiveness of risedronate in osteoporotic postmenopausal women with inflammatory bowel disease: a prospective, parallel, open-label, two-year extension study.

作者信息

Palomba Stefano, Manguso Francesco, Orio Francesco, Russo Tiziana, Oppedisano Rosamaria, Sacchinelli Angela, Falbo Angela, Tolino Achille, Zullo Fulvio, Mastrantonio Pasquale

机构信息

Department of Obstetrics and Gynecology, University "Magna Graecia" of Catanzaro, Catanzaro, Italy.

出版信息

Menopause. 2008 Jul-Aug;15(4 Pt 1):730-6. doi: 10.1097/gme.0b013e318159f190.

Abstract

OBJECTIVE

To evaluate long-term efficacy of risedronate in osteoporotic postmenopausal patients with inflammatory bowel disease (IBD).

DESIGN

A prospective, parallel, open-label, 2-year extension study of a randomized, double-blind, 1-year clinical trial. Eighty-one osteoporotic postmenopausal women with IBD were treated with risedronate (n = 40) or placebo (n = 41). Bone mineral density (BMD), biochemical bone turnover markers, and vertebral and nonvertebral fractures were assessed throughout the study. Data were analyzed using the intent-to-treat principle.

RESULTS

Significant (P < 0.05) differences were observed between risedronate and placebo groups at 1-, 2-, and 3-year follow-up visits in bone turnover markers and in lumbar spine, trochanter, and femoral neck BMD. In participants treated with risedronate, the percentage of changes from baseline in bone turnover markers and in lumbar spine, trochanter, and femoral neck BMD were significantly (P < 0.05) higher at 2- and 3-year follow-up in comparison with baseline and 1-year follow-up, with a significant (P < 0.05) difference between the 2- and 3-year follow-up visits. At the end of the study, the cumulative risk of vertebral and nonvertebral fractures was significantly (P < 0.05) lower in the risedronate group than in the placebo group. The relative risk for new vertebral fractures was 0.456 (95% CI: 0.134-1.559, P = 0.211) and 0.296 (95% CI: 0.121-0.721, P = 0.007) and was 0.209 (95% CI: 0.023-1.867, P = 0.161) and 0.137 (95% CI: 0.030-0.620, P = 0.010), respectively, for new nonvertebral fractures after 2 and 3 years of risedronate treatment.

CONCLUSIONS

In postmenopausal osteoporotic women with IBD, long-term treatment with risedronate is effective in increasing BMD and reducing vertebral and nonvertebral fracture risk.

摘要

目的

评估利塞膦酸盐对患有炎症性肠病(IBD)的绝经后骨质疏松症患者的长期疗效。

设计

一项前瞻性、平行、开放标签的研究,是对一项随机、双盲、1年临床试验的2年延长期研究。81名患有IBD的绝经后骨质疏松症女性接受了利塞膦酸盐治疗(n = 40)或安慰剂治疗(n = 41)。在整个研究过程中评估骨矿物质密度(BMD)、生化骨转换标志物以及椎体和非椎体骨折情况。数据采用意向性分析原则进行分析。

结果

在1年、2年和3年随访时,利塞膦酸盐组和安慰剂组在骨转换标志物以及腰椎、粗隆和股骨颈BMD方面存在显著(P < 0.05)差异。在接受利塞膦酸盐治疗的参与者中,与基线和1年随访相比,在2年和3年随访时骨转换标志物以及腰椎、粗隆和股骨颈BMD从基线的变化百分比显著(P < 0.05)更高,且2年和3年随访之间存在显著(P < 0.05)差异。在研究结束时,利塞膦酸盐组的椎体和非椎体骨折累积风险显著(P < 0.05)低于安慰剂组。利塞膦酸盐治疗2年和3年后新椎体骨折的相对风险分别为0.456(95%CI:0.134 - 1.559,P = 0.211)和0.296(95%CI:0.121 - 0.721,P = 0.007),新非椎体骨折的相对风险分别为0.209(95%CI:0.023 - 1.867,P = 0.161)和0.137(95%CI:0.030 - 0.620,P = 0.010)。

结论

在患有IBD的绝经后骨质疏松症女性中,长期使用利塞膦酸盐治疗可有效提高BMD并降低椎体和非椎体骨折风险。

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