Kamimura Mikio, Uchiyama Shigeharu, Nakamura Yukio, Ikegami Shota, Mukaiyama Keijiro, Kato Hiroyuki
Center for Osteoporosis and Spinal Disorders, Kamimura Orthopaedic Clinic, Matsumoto, Japan.
Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
Ther Clin Risk Manag. 2017 Feb 13;13:161-168. doi: 10.2147/TCRM.S120749. eCollection 2017.
This study aimed to clarify the effects of short-term bisphosphonate (BP) administration in Japanese osteoporotic patients retrospectively. Daily minodronate (MIN) at 1 mg/day (MIN group) or weekly risedronate (RIS) at 17.5 mg/week (RIS group) was primarily prescribed for each patient. We analyzed the laboratory data of 35 cases (18 of MIN and 17 of RIS) before the start of treatment and at 4 months afterward. The changes in 25(OH)D, whole parathyroid hormone (PTH), serum pentosidine, and the bone turnover markers urinary cross-linked N-telopeptide of type I collagen (NTX), serum tartrate-resistant acid phosphatase (TRACP)-5b, bone-specific alkaline phosphatase (BAP), and undercarboxylated osteocalcin were evaluated. Overall, serum 25(OH)D was significantly decreased from 21.8 to 18.4 ng/mL at 4 months, with a percent change of -14.7%. Whole PTH increased significantly from 23.4 to 30.0 pg/mL, with a percent change of 32.1%. Serum pentosidine rose from 0.0306 to 0.0337 μg/mL, with a percent change of 15.2%. In group comparisons, 25(OH)D and pentosidine showed comparable changes in both groups after 4 months of treatment, whereas whole PTH became significantly more increased in the MIN group. All bone turnover markers were significantly decreased at 4 months in both groups. Compared with the RIS group, the MIN group exhibited significantly larger value changes for urinary NTX, serum TRACP-5b, and BAP at the study end point. This study demonstrated that serum 25(OH)D became significantly decreased after only 4 months of BP treatment in Japanese osteoporotic patients and confirmed that MIN more strongly inhibited bone turnover as compared with RIS.
本研究旨在回顾性阐明短期给予双膦酸盐(BP)对日本骨质疏松症患者的影响。主要为每位患者处方每日1毫克的米诺膦酸(MIN组)或每周17.5毫克的利塞膦酸(RIS组)。我们分析了35例患者(MIN组18例,RIS组17例)治疗开始前及治疗4个月后的实验室数据。评估了25(OH)D、全段甲状旁腺激素(PTH)、血清戊糖苷以及骨转换标志物Ⅰ型胶原交联N-端肽(NTX)、血清抗酒石酸酸性磷酸酶(TRACP)-5b、骨特异性碱性磷酸酶(BAP)和未羧化骨钙素的变化。总体而言,血清25(OH)D在4个月时从21.8纳克/毫升显著降至18.4纳克/毫升,变化百分比为-14.7%。全段PTH从23.4皮克/毫升显著升至30.0皮克/毫升,变化百分比为32.1%。血清戊糖苷从0.0306微克/毫升升至0.0337微克/毫升,变化百分比为15.2%。在组间比较中,治疗4个月后两组的25(OH)D和戊糖苷变化相当,而MIN组的全段PTH升高更为显著。两组的所有骨转换标志物在4个月时均显著降低。与RIS组相比,MIN组在研究终点时尿NTX、血清TRACP-5b和BAP的数值变化更大。本研究表明,日本骨质疏松症患者在接受BP治疗仅4个月后血清25(OH)D就显著降低,并证实与RIS相比,MIN对骨转换的抑制作用更强。