Skordis Nicos, Ioannou Yiannis S, Kyriakou Andreas, Savva Savvas C, Efstathiou Elisavet, Savvides Irene, Christou Soteroulla
Paediatric Endocrine Unit, Department of Paediatrics, Makarios Hospital, Nicosia, Cyprus.
Pediatr Endocrinol Rev. 2008 Oct;6 Suppl 1:144-8.
Bisphosphonates are potent inhibitors of osteoclastic bone resorption and have been recently used in thalassaemia major (TM) osteoporosis with encouraging results.
The aim of the study is to investigate the effect of two Bisphosphonate drugs, Alendronate and Pamidronate on bone mass in patients of both genders with TM, treated in our Center.
53 (22 males, 31 females) Thalassaemic patients of Greek Cypriot origin were randomly divided into two groups. 29 patients in group A with a mean age of 33, 32 years were treated with alendronate and 24 patients in group B with a mean age of 34, 36 years received pamidronate for a period of 2 years. The effectiveness of both drugs was estimated based on the change of Bone mineral density (BMD) values of lumbar spine and femoral neck. Bone mineral density (BMD) of lumbar spine and femoral neck was measured by dual-energy X-ray absiorptiometry. All patients were on the standard treatment protocol of Thalassaemia. Statistical analysis was performed with the SPSS program.
After completion of treatment with pamidronate the mean lumbar spine BMD has improved from -2.813 to -2.174 (p<0.001) and the mean hip BMD from -2.138 to -2.078 (p=0.018). The change of spine BMD in patients who received alendronate was from -2.720 to -2.602 (p=0.059) and the changes in BMD at the femoral neck from -2.035 to -2.007 (p=0.829).
This study demonstrates the efficacy of two bisphosphonate drugs in improving BMD values in patients with TM and osteoporosis. Since the origin of bone disease in TM is multifactorial and some of the underlying pathogenic mechanisms are still unclear, further research in this field is needed, which will allow the design of optimal therapeutic measures.
双膦酸盐是破骨细胞骨吸收的有效抑制剂，最近已用于重型地中海贫血（TM）骨质疏松症的治疗，效果令人鼓舞。
本研究旨在调查两种双膦酸盐药物阿仑膦酸钠和帕米膦酸钠对在本中心接受治疗的男女TM患者骨量的影响。
53例（22例男性，31例女性）希腊塞浦路斯裔地中海贫血患者被随机分为两组。A组29例患者，平均年龄33.32岁，接受阿仑膦酸钠治疗；B组24例患者，平均年龄34.36岁，接受帕米膦酸钠治疗，为期2年。基于腰椎和股骨颈骨密度（BMD）值的变化评估两种药物的疗效。采用双能X线吸收法测量腰椎和股骨颈的骨密度。所有患者均采用地中海贫血标准治疗方案。使用SPSS程序进行统计分析。
帕米膦酸钠治疗结束后，腰椎平均BMD从-2.813提高到-2.174（p<0.001），髋部平均BMD从-2.138提高到-2.078（p=0.018）。接受阿仑膦酸钠治疗的患者脊柱BMD变化为从-2.720到-2.602（p=0.059），股骨颈BMD变化为从-2.035到-2.007（p=0.829）。
本研究证明了两种双膦酸盐药物在改善TM和骨质疏松症患者BMD值方面的疗效。由于TM骨病的起源是多因素的，一些潜在的致病机制仍不清楚，因此该领域需要进一步研究，以便设计出最佳治疗措施。
