Ohishi Tsuyoshi, Fujita Tomotada, Suzuki Daisuke, Nishida Tatsuya, Yamamoto Kazufumi, Okabayashi Ryo, Ushirozako Hiroki, Banno Tomohiro, Matsuyama Yukihiro
a Department of Orthopaedic Surgery , Enshu Hospital , Hamamatsu , Japan.
b Department of Orthopaedic Surgery , Shintoshi Hospital , Iwata , Japan.
Endocr Res. 2017 Aug;42(3):232-240. doi: 10.1080/07435800.2017.1292527. Epub 2017 Mar 20.
Monthly regimen of minodronate for osteoporosis more than two years has not been reported yet. The aim of this study is to elucidate the effect of monthly minodronate (M-MIN) on bone mineral density (BMD) and serum pentosidine (Pen) during 27 months.
The study consisted of 52 newly treated patients (73.3 ± 8.8 years) (new group) and 47 patients (75.9 ± 9.5 years) who were switched from either alendronate or risedronate (switch group). Monthly minodronate (50 mg/every 4 weeks) was administered for 27 months. Lumbar, femoral neck, and total hip BMDs and serum pentosidine were monitored at baseline and after 9, 18, and 27 months of treatment.
In the new condition, lumbar, neck, and total hip BMDs increased significantly by 9.07%, 3.15%, and 3.06%, respectively. Only the lumbar BMD significantly increased in the switch condition. Serum Pen increased in both groups in a time-dependent manner. In the group switch, multivariate logistic regression analysis revealed that the initial change in serum intact procollagen type I N-terminal propeptide (P1NP) at 9 months was an independent predictor of changes in neck and total hip BMDs at 27 months (OR = 1.039, 95% CI 1.003-1.077, p = 0.032 for neck and OR = 1.055, 95% CI 1.009-1.104, p = 0.020 for total hip).
Monthly minodronate treatment increased BMDs in newly treated patients over 27 months. Serum Pen increased with M-MIN therapy, possibly indicating prolonged bone turnover. The initial 9-month changes in serum P1NP predicted the 27-month changes in hip BMDs when M-MIN replaced alendronate or risedronate.
尚未有关于米诺膦酸盐治疗骨质疏松症超过两年的每月治疗方案的报道。本研究的目的是阐明每月使用米诺膦酸盐（M-MIN）在27个月期间对骨密度（BMD）和血清戊糖苷（Pen）的影响。
本研究包括52例新接受治疗的患者（73.3±8.8岁）（新治疗组）和47例从阿仑膦酸盐或利塞膦酸盐转换而来的患者（转换组）（75.9±9.5岁）。每月给予米诺膦酸盐（50mg/每4周），持续27个月。在基线以及治疗9、18和27个月后监测腰椎、股骨颈和全髋部的骨密度以及血清戊糖苷。
在新治疗组中，腰椎、股骨颈和全髋部的骨密度分别显著增加了9.07%、3.15%和3.06%。在转换组中，只有腰椎骨密度显著增加。两组血清Pen均呈时间依赖性增加。在转换组中，多因素逻辑回归分析显示，9个月时血清I型原胶原N端前肽（P1NP）的初始变化是27个月时股骨颈和全髋部骨密度变化的独立预测因素（股骨颈：OR = 1.039，95%CI 1.003 - 1.077，p = 0.032；全髋部：OR = 1.055，95%CI 1.009 - 1.104，p = 0.020）。
每月使用米诺膦酸盐治疗在27个月内可增加新治疗患者的骨密度。血清Pen随M-MIN治疗增加，可能表明骨转换延长。当M-MIN替代阿仑膦酸盐或利塞膦酸盐时，血清P1NP在9个月时的初始变化可预测27个月时髋部骨密度的变化。
