Department of Internal Medicine, Virginia Commonwealth University School of Medicine, VA, USA.
Endocr Pract. 2010 Nov-Dec;16(6):960-7. doi: 10.4158/EP10059.OR.
To study changes in bone mineral density (BMD) and a bone resorption marker in elderly men who received off-label zoledronic acid for osteoporosis treatment.
We conducted a retrospective review of medical records of 50 male veterans who had received at least one 4-mg intravenous infusion of zoledronic acid and had BMD measurements at 2 of 3 skeletal sites both before the infusion and at a mean of 2.2 years after the infusion. Patients were classified into those who had never received bisphosphonate therapy versus those who had previously received such treatment.
In our study population, 66% of patients had been prescribed orally administered bisphosphonates or intravenously administered pamidronate before receiving zoledronic acid. Larger increases in spine BMD (6.7% versus 3.4% [P<.05]; per year: 2.8% versus 1.2% [P<.01]) and total hip BMD (3.2% versus 0.1% [P<.03]; per year: 1.3% versus 0.02% [P<.02]) occurred after infusion of zoledronic acid in bisphosphonate-naïve patients in comparison with those who had previous bisphosphonate exposure. In addition, 26 of 50 patients (52%) had suppressed urinary N-terminal telopeptide of cross-linked collagen type I (NTx) (a bone turnover marker) at 12 months, and 5 men had NTx suppression for 24 months after infusion.
Our data suggest that 4 mg of intravenously administered zoledronic acid is an effective treatment for increasing BMD in a "real-world" population of men with osteoporosis. The prolonged suppression of urinary NTx after zoledronic acid infusion raises the question of whether this treatment could be given less frequently than every year. The changes seen in BMD during a mean period of 2 years were similar to those reported in clinical studies with alendronate therapy in men and zoledronic acid treatment in women.
研究接受唑来膦酸治疗骨质疏松症的老年男性骨密度（BMD）和骨吸收标志物的变化。
我们对 50 名男性退伍军人的医疗记录进行了回顾性分析，这些患者至少接受了一次 4mg 静脉注射唑来膦酸治疗，并且在输注前和输注后平均 2.2 年的 3 个骨骼部位中的 2 个部位进行了 BMD 测量。患者分为未接受过双膦酸盐治疗和先前接受过此类治疗的两组。
在我们的研究人群中，66%的患者在接受唑来膦酸治疗前曾接受过口服双膦酸盐或静脉注射帕米膦酸治疗。与先前接受过双膦酸盐治疗的患者相比，在未接受过双膦酸盐治疗的患者中，唑来膦酸输注后脊柱 BMD （6.7%比 3.4%[P<.05]；每年：2.8%比 1.2%[P<.01]）和全髋 BMD （3.2%比 0.1%[P<.03]；每年：1.3%比 0.02%[P<.02]）的增加更大。此外，在输注唑来膦酸后 12 个月时，50 名患者中有 26 名（52%）的尿 N 末端肽交联型胶原（CTX）（骨转换标志物）被抑制，5 名患者的 NTx 抑制持续了 24 个月。
我们的数据表明，4mg 静脉注射唑来膦酸是治疗骨质疏松症男性患者增加 BMD 的有效方法。唑来膦酸输注后尿 NTx 的长期抑制提出了这样一个问题，即这种治疗是否可以少于每年一次。在平均 2 年的时间内，BMD 的变化与接受阿伦膦酸盐治疗的男性和唑来膦酸治疗的女性的临床研究报告的变化相似。
