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韩国骨质疏松症患者每月服用利塞膦酸钠联合胆钙化醇后 25-羟维生素 D 水平和骨标志物的早期变化。

Early changes in 25-hydroxyvitamin D levels and bone markers after monthly risedronate with cholecalciferol in Korean patients with osteoporosis.

机构信息

Department of Internal Medicine, Kyung Hee University, South Korea.

出版信息

Clin Interv Aging. 2013;8:597-603. doi: 10.2147/CIA.S44395. Epub 2013 May 30.

Abstract

PURPOSE

This study investigated the efficacy and safety of monthly risedronate, with and without cholecalciferol, on 25-hydroxyvitamin D (25[OH]D) levels and bone markers in Korean patients with osteoporosis.

METHODS

A randomized, double-blinded, prospective, 16-week clinical trial was conducted in ten hospitals. A total of 150 subjects with osteoporosis were randomized to one of the two treatment groups: RSDM+ (monthly risedronate 150 mg and cholecalciferol 30,000 IU combined in a single pill, n = 74) or RSDM (monthly risedronate 150 mg alone, n = 76). We measured serum levels of 25-hydroxyvitamin D (25[OH]D), parathyroid hormone (PTH), and bone markers, as well as performing muscle-function tests at baseline and after 16 weeks of treatment.

RESULTS

After 16 weeks, serum 25(OH)D levels significantly increased from 17.8 to 26.8 ng/mL in the RSDM+ group, but did not change in the RSDM group. The RSDM+ group exhibited significantly decreased serum PTH from 46 to 36.7 pg/mL, while the RSDM group showed a tendency for PTH to increase from 38 to 40.6 pg/mL. In both groups, serum bone-specific alkaline phosphatase and C-terminal telopeptide rapidly declined, with significance at 16 weeks; there were no significant differences between the groups.

CONCLUSION

A once-monthly pill of risedronate and cholecalciferol provided equivalent antiresorptive efficacy to risedronate alone in terms of bone turnover and improved 25(OH)D levels over the 16-week treatment period without significant adverse events in Korean patients with osteoporosis.

摘要

目的

本研究旨在探讨每月利塞膦酸钠联合或不联合胆钙化醇对韩国骨质疏松症患者 25-羟维生素 D(25[OH]D)水平和骨标志物的疗效和安全性。

方法

在十家医院进行了一项随机、双盲、前瞻性、为期 16 周的临床试验。共有 150 名骨质疏松症患者被随机分为两组:RSDM+(每月利塞膦酸钠 150mg 与胆钙化醇 30000IU 联合制成一片,n=74)或 RSDM(每月利塞膦酸钠 150mg 单独使用,n=76)。我们在基线和治疗 16 周后测量了血清 25-羟维生素 D(25[OH]D)、甲状旁腺激素(PTH)和骨标志物水平,并进行了肌肉功能测试。

结果

16 周后,RSDM+组血清 25(OH)D 水平从 17.8ng/ml 显著升高至 26.8ng/ml,而 RSDM 组无变化。RSDM+组血清 PTH 从 46pg/ml 显著下降至 36.7pg/ml,而 RSDM 组 PTH 有升高趋势,从 38pg/ml 升高至 40.6pg/ml。两组患者血清骨特异性碱性磷酸酶和 C 端肽均迅速下降,16 周时有统计学意义;两组间无显著差异。

结论

在韩国骨质疏松症患者中,利塞膦酸钠和胆钙化醇的每月一次的联合片剂在 16 周的治疗期间提供了与单独使用利塞膦酸钠相当的抗吸收疗效,在改善 25(OH)D 水平方面优于单独使用利塞膦酸钠,且无明显不良事件。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8345/3673862/348c760d8110/cia-8-597Fig1.jpg

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