Catalano A, Gaudio A, Morabito N, Basile G, Agostino R M, Xourafa A, Atteritano M, Morini E, Natale G, Lasco A
Department of Clinical and Experimental Medicine, University Hospital of Messina, University Hospital "G. Martino", Via C. Valeria, 98125, Messina, Italy.
Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
J Endocrinol Invest. 2017 Aug;40(8):851-857. doi: 10.1007/s40618-016-0606-6. Epub 2017 Mar 22.
Denosumab has been proven to reduce fracture risk in breast cancer (BC) women under aromatase inhibitors (AIs). Quantitative ultrasound (QUS) provides information on the structure and elastic properties of bone. Our aim was to assess bone health by phalangeal QUS and by dual-energy X-ray absorptiometry (DXA), and to evaluate bone turnover in AIs-treated BC women receiving denosumab.
35 Postmenopausal BC women on AIs were recruited (mean age 61.2 ± 4.5 years) and treated with denosumab 60 mg administered subcutaneously every 6 months. Phalangeal QUS parameters [Amplitude Dependent Speed of Sound (AD-SoS), Ultrasound Bone Profile Index (UBPI), Bone Transmission Time (BTT)] and DXA at lumbar spine and femoral neck were performed. Serum C-telopeptide of type 1 collagen (CTX) and bone-specific alkaline phosphatase (BSAP) were also measured. The main outcomes were compared with a control group not receiving denosumab (n = 39).
In patients treated with denosumab, differently from controls, QUS and DXA measurements improved after 24 months, and a reduction of CTX and BSAP was detected at 12 and 24 months in comparison to baseline (P < 0.05). The percent changes (Δ) of QUS measurements were significantly associated with ΔBMD at femoral neck, and ΔCTX and ΔBSAP were associated with ΔBMD at lumbar spine (r = -0.39, P = 0.02; r = -0.49, P = 0.01, respectively).
Denosumab preserves bone health as assessed by phalangeal QUS and DXA. Since inexpensive and radiation-free, phalangeal QUS may be considered in the follow-up of AIs-treated BC women receiving denosumab.
地诺单抗已被证实可降低接受芳香化酶抑制剂（AI）治疗的乳腺癌（BC）女性的骨折风险。定量超声（QUS）可提供有关骨骼结构和弹性特性的信息。我们的目的是通过指骨QUS和双能X线吸收法（DXA）评估骨骼健康状况，并评估接受地诺单抗治疗的AI治疗的BC女性的骨转换情况。
招募了35名接受AI治疗的绝经后BC女性（平均年龄61.2±4.5岁），每6个月皮下注射60mg地诺单抗进行治疗。进行指骨QUS参数[振幅依赖声速（AD-SoS）、超声骨轮廓指数（UBPI）、骨传播时间（BTT）]以及腰椎和股骨颈的DXA检查。还测量了血清1型胶原C端肽（CTX）和骨特异性碱性磷酸酶（BSAP）。将主要结果与未接受地诺单抗的对照组（n = 39）进行比较。
与对照组不同，接受地诺单抗治疗的患者在24个月后QUS和DXA测量结果有所改善，与基线相比，在12个月和24个月时检测到CTX和BSAP降低（P < 0.05）。QUS测量的百分比变化（Δ）与股骨颈的Δ骨密度显著相关，ΔCTX和ΔBSAP与腰椎的Δ骨密度相关（r分别为-0.39，P = 0.02；r = -0.49，P = 0.01）。
根据地诺单抗评估，地诺单抗可维持骨骼健康。由于指骨QUS价格低廉且无辐射，在接受地诺单抗治疗的AI治疗的BC女性的随访中可考虑使用。
