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地诺单抗治疗韩国绝经后骨质疏松症女性的评估:随机、双盲、安慰剂对照试验及开放标签延长期试验

Assessment of Denosumab in Korean Postmenopausal Women with Osteoporosis: Randomized, Double-Blind, Placebo-Controlled Trial with Open-Label Extension.

作者信息

Koh Jung Min, Chung Dong Jin, Chung Yoon Sok, Kang Moo Il, Kim In Ju, Min Yong Ki, Oh Han Jin, Park Il Hyung, Lee Yil Seob, Kravitz Barbara, Waterhouse Brian, Nino Antonio, Fitzpatrick Lorraine A

机构信息

Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Division of Endocrinology and Metabolism, Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.

出版信息

Yonsei Med J. 2016 Jul;57(4):905-14. doi: 10.3349/ymj.2016.57.4.905.

Abstract

PURPOSE

The efficacy and safety of denosumab was compared with placebo in Korean postmenopausal women with osteoporosis in this phase III study.

MATERIALS AND METHODS

Women aged 60 to 90 years with a T-score of <-2.5 and ≥-4.0 at the lumbar spine or total hip were randomized to a single 60 mg subcutaneous dose of denosumab or placebo for the 6-month double-blind phase. Eligible subjects entered the 6-month open-label extension phase and received a single dose of denosumab 60 mg.

RESULTS

Baseline demographics were similar in the 62 denosumab- and 64 placebo-treated subjects who completed the double-blind phase. Treatment favored denosumab over placebo for the primary endpoint {mean percent change from baseline in lumbar spine bone mineral density (BMD) at Month 6 [3.2% (95% confidence interval 2.1%, 4.4%; p<0.0001)]}; and secondary endpoints (mean percent change from baseline in lumbar spine BMD at Month 1, total hip, femoral neck, and trochanter BMD at Months 1 and 6, and median percent change from baseline in bone turnover markers at Months 1, 3, and 6). Endpoint improvements were sustained over 12 months in the open-label extension (n=119). There were no new or unexpected safety signals.

CONCLUSION

Denosumab was well tolerated and effective in increasing BMD and decreasing bone turnover markers over a 12-month period in Korean postmenopausal women. The findings of this study demonstrate that denosumab has beneficial effects on the measures of osteoporosis in Korean postmenopausal women.

摘要

目的

在这项III期研究中,比较了地诺单抗与安慰剂在韩国绝经后骨质疏松症女性中的疗效和安全性。

材料与方法

年龄在60至90岁、腰椎或全髋部T值<-2.5且≥-4.0的女性被随机分为接受单次60mg皮下注射地诺单抗或安慰剂,进行为期6个月的双盲阶段。符合条件的受试者进入为期6个月的开放标签延长期,接受单次60mg地诺单抗治疗。

结果

完成双盲阶段的62名接受地诺单抗治疗和64名接受安慰剂治疗的受试者的基线人口统计学特征相似。在主要终点方面,地诺单抗治疗优于安慰剂{第6个月时腰椎骨矿物质密度(BMD)较基线的平均变化百分比[3.2%(95%置信区间2.1%,4.4%;p<0.0001)]};以及次要终点(第1个月时腰椎BMD较基线的平均变化百分比、第1个月和第6个月时全髋、股骨颈和大转子BMD较基线的平均变化百分比,以及第1、3和6个月时骨转换标志物较基线的中位变化百分比)。在开放标签延长期(n=119),终点改善持续了12个月。没有新的或意外的安全信号。

结论

在韩国绝经后女性中,地诺单抗在12个月期间耐受性良好,可有效增加BMD并降低骨转换标志物。本研究结果表明,地诺单抗对韩国绝经后女性的骨质疏松症指标有有益影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/afbe/4951467/dd73a68c50bd/ymj-57-905-g001.jpg

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