Eekman Danielle A, Vis Marijn, Bultink Irene E M, Derikx Harm J G M, Dijkmans Ben A C, Lems Willem F
Department of Rheumatology, VU University Medical Center, Amsterdam, the Netherlands.
BMC Musculoskelet Disord. 2009 Jul 15;10:86. doi: 10.1186/1471-2474-10-86.
In case of contraindications or intolerance during treatment with oral bisphosphonates (OB), administration of pamidronate intravenously is a widely used alternative. In this study we compared the effect on change in bone mineral density (BMD) of the spine and hip during long term treatment with pamidronate iv in comparison to OB.
We studied 61 patients receiving treatment for at least two years. In case of contraindications or intolerance (within 3 months) of an OB, pamidronate iv was started. BMD was measured on a Hologic 4500 and a Lunar DPX-IQ at the spine (L1-L4) and total hip.
Thirty-one patients were enrolled in the OB group and 30 in the intravenous pamidronate group. Mean follow-up duration (SD) was 4.3 (1.3) years. We observed a significant increase (p < 0.001) in spinal BMD, both in the OB group (8.3%) as well as in the pamidronate iv group (6.1%), but no significant difference in BMD change between the OB and pamidronate iv groups. At the hips, we observed a tendency to increased BMD in both groups, 1.1% in the OB and 1.4% in the pamidronate iv group.
We conclude that intravenous pamidronate is a good alternative for oral bisphosphonates in the treatment of osteoporosis in patients with contraindications or intolerance during treatment with oral bisphosphonates.
在口服双膦酸盐（OB）治疗期间出现禁忌症或不耐受情况时，静脉注射帕米膦酸盐是一种广泛使用的替代方法。在本研究中，我们比较了与口服双膦酸盐相比，长期静脉注射帕米膦酸盐治疗对脊柱和髋部骨密度（BMD）变化的影响。
我们研究了61例接受治疗至少两年的患者。如果出现口服双膦酸盐的禁忌症或不耐受（在3个月内），则开始静脉注射帕米膦酸盐。使用Hologic 4500和Lunar DPX-IQ在脊柱（L1-L4）和全髋部测量骨密度。
口服双膦酸盐组纳入31例患者，静脉注射帕米膦酸盐组纳入30例患者。平均随访时间（标准差）为4.3（1.3）年。我们观察到口服双膦酸盐组（8.3%）和静脉注射帕米膦酸盐组（6.1%）的脊柱骨密度均显著增加（p<0.001），但口服双膦酸盐组和静脉注射帕米膦酸盐组之间的骨密度变化无显著差异。在髋部，我们观察到两组均有骨密度增加的趋势，口服双膦酸盐组为1.1%，静脉注射帕米膦酸盐组为1.4%。
我们得出结论，对于口服双膦酸盐治疗期间出现禁忌症或不耐受的骨质疏松症患者，静脉注射帕米膦酸盐是口服双膦酸盐的良好替代方法。
