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用于治疗绝经后骨质疏松症的巴泽多昔芬的安全性和耐受性:一项为期 5 年、随机、安慰剂对照的 3 期临床试验结果。

Safety and tolerability of bazedoxifene in postmenopausal women with osteoporosis: results of a 5-year, randomized, placebo-controlled phase 3 trial.

机构信息

Panorama MediClinic and University of Stellenbosch, Room 118 Parow 7500, Cape Town, South Africa.

出版信息

Osteoporos Int. 2011 Feb;22(2):567-76. doi: 10.1007/s00198-010-1302-6. Epub 2010 Jun 10.

Abstract

UNLABELLED

Findings from this 5-year phase 3 study of postmenopausal women with osteoporosis showed that bazedoxifene was associated with an overall favorable safety and tolerability profile, with no evidence of endometrial or breast stimulation. Overall, the results at 5 years were consistent with those seen at 3 years.

INTRODUCTION

We report safety and tolerability findings from a 5-year randomized, double-blind, phase 3 study of bazedoxifene in postmenopausal women with osteoporosis.

METHODS

In the core study, healthy postmenopausal women with osteoporosis (N=7,492; mean age, 66.4 years) were randomized to daily doses of bazedoxifene 20 or 40 mg, raloxifene 60 mg, or placebo for 3 years. During the 2-year study extension, the raloxifene 60-mg treatment arm was discontinued after the 3-year database was finalized, and subjects receiving bazedoxifene 40 mg were transitioned in a blinded manner to bazedoxifene 20 mg (bazedoxifene 40-/20-mg group) after 4 years. Safety and tolerability data are reported for subjects in the bazedoxifene 20- and 40-/20-mg and placebo groups; efficacy findings are reported elsewhere.

RESULTS

A total of 3,146 subjects in the bazedoxifene 20- and 40-mg and placebo groups were enrolled in the extension study (years 4 and 5). Overall, the 5-year incidence of adverse events (AEs), serious AEs, and discontinuations due to AEs were similar among groups. The incidence of hot flushes and leg cramps was higher with bazedoxifene compared with placebo. Venous thromboembolic events, primarily deep vein thrombosis, were more frequently reported in the bazedoxifene groups compared with the placebo group. Reports of cardiac disorders and cerebrovascular events were few and evenly distributed among groups. Bazedoxifene showed a neutral effect on the breast and endometrium.

CONCLUSION

Bazedoxifene was associated with an overall favorable safety and tolerability profile in postmenopausal women with osteoporosis over 5 years of therapy, consistent with findings at 3 years.

摘要

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这项为期 5 年的骨质疏松症绝经后妇女的 3 期研究结果表明,巴多昔芬具有整体良好的安全性和耐受性,没有子宫内膜或乳房刺激的证据。总的来说,5 年的结果与 3 年的结果一致。

引言

我们报告了一项为期 5 年、随机、双盲、3 期巴多昔芬治疗骨质疏松症绝经后妇女的安全性和耐受性研究结果。

方法

在核心研究中,健康的骨质疏松症绝经后妇女(N=7492;平均年龄 66.4 岁)被随机分配每日接受巴多昔芬 20 或 40mg、雷洛昔芬 60mg 或安慰剂治疗 3 年。在为期 2 年的研究延长期间,在 3 年数据库最终确定后,雷洛昔芬 60mg 治疗组停止治疗,接受巴多昔芬 40mg 的受试者在 4 年后以盲法方式转换为巴多昔芬 20mg(巴多昔芬 40/20mg 组)。报告了接受巴多昔芬 20mg 和 40/20mg 及安慰剂组受试者的安全性和耐受性数据;疗效结果在其他地方报告。

结果

共有 3146 名接受巴多昔芬 20mg 和 40mg 及安慰剂组的受试者参加了延长研究(第 4 年和第 5 年)。总体而言,各组不良事件(AE)、严重 AE 和因 AE 停药的 5 年发生率相似。与安慰剂相比,热潮红和腿部痉挛的发生率更高。与安慰剂组相比,巴多昔芬组更频繁报告静脉血栓栓塞事件,主要是深静脉血栓形成。心脏疾病和脑血管事件的报告很少,各组分布均匀。巴多昔芬对乳房和子宫内膜的影响中性。

结论

在 5 年的治疗中,巴多昔芬在骨质疏松症绝经后妇女中具有整体良好的安全性和耐受性,与 3 年的研究结果一致。

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