Kitamura Noboru, Shiraiwa Hidetaka, Inomata Hirotake, Nozaki Takamasa, Ikumi Natsumi, Sugiyama Kaita, Nagasawa Yousuke, Karasawa Hiromi, Iwata Mitsuhiro, Matsukawa Yoshihiro, Takei Masami
Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan.
Int J Rheum Dis. 2018 Apr;21(4):813-820. doi: 10.1111/1756-185X.12844. Epub 2016 Mar 1.
Minodronic acid hydrate, an oral bisphosphonate, has a greater inhibitory effect on bone resorption than do other approved drugs; however, this has been studied only in patients with primary osteoporosis. Here, we administered minodronic acid hydrate to patients with steroid-induced osteoporosis who have been treated with steroids for rheumatoid arthritis or other collagen diseases, and the efficacy and safety of minodronic acid hydrate were prospectively investigated.
Twenty-five patients treated in our rheumatology clinic received minodronic acid hydrate 1 mg/day. The changes in bone mineral density (BMD) and bone turnover markers were investigated at 3 and 6 months, and adverse events, including the presence or absence of an incident osteoporotic fracture, were examined over a period of 6 months.
Percent changes in BMD of the lumbar spine and femur significantly increased. The values of bone turnover markers significantly decreased. There were no patients with a radiographically apparent incident fracture. Adverse events included toothache for which the patient discontinued the treatment and three cases of gastrointestinal disorder that did not lead to discontinuation, and thus minodronic acid hydrate was well tolerated.
Here, we show that minodronic acid hydrate is effectively and safely used for treatment of steroid-induced osteoporosis.
米诺膦酸水合物是一种口服双膦酸盐,与其他已获批药物相比,它对骨吸收的抑制作用更强;然而,此前仅在原发性骨质疏松症患者中进行过研究。在此,我们对因类风湿关节炎或其他胶原病接受类固醇治疗而导致类固醇性骨质疏松症的患者给予米诺膦酸水合物,并对米诺膦酸水合物的疗效和安全性进行了前瞻性研究。
我们风湿科门诊的25例患者接受了每日1毫克的米诺膦酸水合物治疗。在3个月和6个月时分别调查骨密度(BMD)和骨转换标志物的变化,并在6个月期间检查不良事件,包括是否发生骨质疏松性骨折。
腰椎和股骨的骨密度百分比变化显著增加。骨转换标志物的值显著降低。没有患者发生影像学上明显的新发骨折。不良事件包括患者因牙痛停药以及3例未导致停药的胃肠道疾病,因此米诺膦酸水合物耐受性良好。
在此,我们表明米诺膦酸水合物可有效且安全地用于治疗类固醇性骨质疏松症。