Osteoporosis Research Unit, King's College London, Guy's Hospital Campus, Great Maze Pond, London, UK.
Osteoporos Int. 2012 Aug;23(8):2107-16. doi: 10.1007/s00198-011-1805-9. Epub 2011 Oct 8.
The aim of this study was to examine the effects of bisphosphonate discontinuation on bone metabolism at the spine and hip measured using (18) F-fluoride PET. Bone metabolism at the spine remained stable following discontinuation of alendronate and risedronate at 1 year but increased in the hip in the alendronate group only.
Bisphosphonates such as alendronate (ALN) or risedronate (RIS) have persistent effects on spine BMD following discontinuation.
Positron emission tomography (PET) was used to examine regional bone metabolism in 20 postmenopausal women treated with ALN (n = 11) or RIS (n = 9) for a minimum of 3 years at screening (range 3-9 years, mean 5 years for both groups). Subjects underwent a dynamic scan of the lumbar spine and a static scan of both hips at baseline and 6 and 12 months following treatment discontinuation. (18) F-fluoride plasma clearance (K(i)) at the spine was calculated using a three-compartment model. Standardised uptake values (SUV) were calculated for the spine, total hip, femoral neck and femoral shaft. Measurements of BMD and biochemical markers of bone turnover were also performed.
With the exception of a significant decrease in spine BMD in the ALN group, BMD remained stable. Bone turnover markers increased significantly from baseline by 12 months for both study groups. Measurements of K(i) and SUV at the spine and femoral neck did not change significantly in either group. SUV at the femoral shaft and total hip increased significantly but in the ALN group only, increasing by 33.8% (p = 0.028) and 24.0% (p = 0.013), respectively.
Bone metabolism at the spine remained suppressed following treatment discontinuation. A significant increase in SUV at the femoral shaft and total hip after 12 months was observed but for the ALN group only. This study was small, and further clinical studies are required to fully evaluate the persistence of BP treatment.
本研究旨在使用（18）F-氟化物 PET 检测脊柱和髋部的骨代谢，以探讨双膦酸盐停药后的作用。阿仑膦酸钠和利塞膦酸钠停药 1 年后，脊柱的骨代谢仍保持稳定，但仅在阿仑膦酸钠组髋部增加。
阿仑膦酸钠（ALN）或利塞膦酸钠（RIS）等双膦酸盐在停药后对脊柱 BMD 仍有持续作用。
对 20 名接受 ALN（n=11）或 RIS（n=9）治疗至少 3 年的绝经后妇女进行正电子发射断层扫描（PET），以检测骨代谢。（18）F-氟化物血浆清除率（K(i)）采用三室模型计算。计算脊柱、全髋、股骨颈和股骨骨干的标准化摄取值（SUV）。还进行了 BMD 和骨转换生化标志物的测量。
除 ALN 组脊柱 BMD 显著下降外，BMD 保持稳定。两组的骨转换标志物均在 12 个月时从基线显著增加。两组脊柱和股骨颈的 K(i)和 SUV 测量均无显著变化。但仅在 ALN 组，股骨骨干和全髋的 SUV 显著增加，分别增加 33.8%（p=0.028）和 24.0%（p=0.013）。
停药后脊柱的骨代谢仍受到抑制。12 个月后观察到股骨骨干和全髋的 SUV 显著增加，但仅在 ALN 组。本研究规模较小，需要进一步的临床研究来全面评估 BP 治疗的持续性。
