McNeilly Thomas, McNally Colette, Finch Michael, Beringer Timothy
Osteoporosis Service, Belfast Health and Social Care Trust, Musgrave Park Hospital, Belfast BT9 7JB.
Ulster Med J. 2013 May;82(2):89-93.
Osteoporosis results in significant morbidity and mortality for a large number of patients within Northern Ireland. Recombinant PTH (Teriparatide) is one of a growing number of treatment options for the disease.
A retrospective analysis was carried out for all patients who had been commenced on Teriparatide since it was first used in the Belfast Health and Social Care Trust (BHSCT) in 2007. Patient demographics, clinical history and prior treatment were recorded prior to an eighteen month treatment protocol. Outcome measures including bone densitometry, bone turnover markers and health status were assessed on commencement and completion.
138 patients have commenced teriparatide therapy since 2007 (9 male, 129 female). At the time of analysis 60 patients had completed treatment, 53 patients were receiving ongoing treatment and 25 patients did not complete the 18 month course. On completion vertebral bone mineral density (BMD) had increased by 8.3% while femoral neck BMD had increased by 3.5%. Bone turnover markers demonstrated a significant increase of bone formation and resorption at 4 months, with a smaller increase at 18 months. Health outcome measures (EuroQoL-5 and patient visual analogue scale) indicated improvement in the quality of life of patients of those who completed the treatment course.
Experience in the BHSCT with teriparatide since 2007 demonstrates improvement in BMD comparable to published data, changes in bone turnover markers consistent with increased bone remodeling and better health outcomes for patients.
骨质疏松症给北爱尔兰大量患者带来了严重的发病率和死亡率。重组甲状旁腺激素(特立帕肽)是该疾病越来越多的治疗选择之一。
对自2007年在贝尔法斯特健康和社会护理信托基金(BHSCT)首次使用特立帕肽以来开始使用该药的所有患者进行回顾性分析。在18个月的治疗方案之前记录患者的人口统计学、临床病史和先前治疗情况。在开始和结束时评估包括骨密度测定、骨转换标志物和健康状况在内的结果指标。
自2007年以来,138例患者开始接受特立帕肽治疗(9例男性,129例女性)。在分析时,60例患者完成了治疗,53例患者正在接受治疗,25例患者未完成18个月疗程。完成治疗时,椎体骨矿物质密度(BMD)增加了8.3%,而股骨颈BMD增加了3.5%。骨转换标志物显示在4个月时骨形成和吸收显著增加,在18个月时增加较小。健康结果指标(欧洲五维健康量表和患者视觉模拟量表)表明完成治疗疗程的患者生活质量有所改善。
BHSCT自2007年以来使用特立帕肽的经验表明,骨密度的改善与已发表的数据相当,骨转换标志物的变化与骨重塑增加一致,患者的健康结果更好。