Ebina K, Noguchi T, Hirao M, Hashimoto J, Kaneshiro S, Yukioka M, Yoshikawa H
Osteoporos Int. 2016 Jan;27(1):351-9. doi: 10.1007/s00198-015-3369-6.
Switching weekly ALN or RIS to monthly MIN in patients with RA, of whom two-thirds were treated with low-dose PSL, significantly decreased bone turnover markers and increased BMD at 12 months, suggesting that monthly MIN may be an effective alternative treatment option of oral bisphosphonate treatment.
The aim of this prospective, observational study was to evaluate the effects of switching weekly alendronate (ALN 35 mg) or risedronate (RIS 17.5 mg) to monthly minodronate (MIN 50 mg) in patients with rheumatoid arthritis (RA).
Patient characteristics were as follows: n = 172; 155 postmenopausal women, age 65.5 (44–87) years; T-score of lumbar spine (LS), −1.4; total hip (TH), −1.8; femoral neck (FN), −2.1; dose and rate of oral prednisolone (2.3 mg/day), 69.1 %; prior duration of ALN or RIS, 46.6 months; were allocated, based on their preference, to either the (1) continue group (n = 88), (2) switch-from-ALN group (n = 44), or (3) switch-from-RIS group (n = 40).
After 12 months, increase in BMD was significantly greater in group 3 compared to group 1: LS (4.1 vs 1.2 %; P < 0.001), TH (1.9 vs −0.7 %; P < 0.01), and FN (2.7 vs −0.5 %; P < 0.05); and in group 2 compared to group 1: LS (3.2 vs 1.2 %; P < 0.05) and TH (1.5 vs −0.7 %; P < 0.01). The decrease in bone turnover markers was significantly greater in group 3 compared to group 1: TRACP-5b (−37.3 vs 2.5 %; P < 0.001), PINP (−24.7 vs −6.2 %; P < 0.05), and ucOC (−39.2 vs 13.0 %; P < 0.05); and in group 2 compared to group 1: TRACP-5b (−12.5 vs 2.5 %; P < 0.05) at 12 months.
Switching weekly ALN or RIS to monthly MIN in patients with RA may be an effective alternative treatment option of oral bisphosphonate treatment.
在类风湿关节炎（RA）患者中，将每周一次的阿仑膦酸钠（ALN）或利塞膦酸钠（RIS）换成每月一次的米诺膦酸（MIN），其中三分之二的患者接受低剂量泼尼松龙（PSL）治疗，在12个月时显著降低了骨转换标志物并增加了骨密度（BMD），这表明每月一次的MIN可能是口服双膦酸盐治疗的一种有效替代治疗选择。
这项前瞻性观察性研究的目的是评估将类风湿关节炎（RA）患者的每周阿仑膦酸钠（ALN 35mg）或利塞膦酸钠（RIS 17.5mg）换成每月米诺膦酸（MIN 50mg）的效果。
患者特征如下：n = 172；155名绝经后女性，年龄65.5（44 - 87）岁；腰椎（LS）T值为−1.4；全髋关节（TH）为−1.8；股骨颈（FN）为−2.1；口服泼尼松龙剂量和比率（2.3mg/天），69.1%；之前使用ALN或RIS的持续时间，46.6个月；根据他们的偏好，被分配到（1）继续组（n = 88）、（2）从ALN转换组（n = 44）或（3）从RIS转换组（n = 40）。
12个月后，与第1组相比，第3组的BMD增加显著更大：LS（4.1%对1.2%；P < 0.001）、TH（1.9%对−0.7%；P < 0.01）和FN（2.7%对−0.5%；P < 0.05）；与第1组相比，第2组的情况为：LS（3.2%对1.2%；P < 0.05）和TH（1.5%对−0.7%；P < 0.01）。与第1组相比，第3组的骨转换标志物降低显著更大：抗酒石酸酸性磷酸酶5b（TRACP - 5b）（−37.3%对2.5%；P < 0.001）、I型前胶原氨基端前肽（PINP）（−24.7%对−6.2%；P < 0.05）和未羧化骨钙素（ucOC）（−39.2%对13.0%；P < 0.05）；与第1组相比，第2组在12个月时的TRACP - 5b为（−12.5%对2.5%；P < 0.05）。
在RA患者中将每周一次的ALN或RIS换成每月一次的MIN可能是口服双膦酸盐治疗的一种有效替代治疗选择。
