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类风湿关节炎患者短期每日使用特立帕肽

Short-term daily teriparatide in patients with rheumatoid arthritis.

作者信息

Kaneko Tetsuya, Okamura Koichi, Yonemoto Yukio, Okura Chisa, Suto Takahito, Tachibana Masahiro, Tamura Yasuyuki, Inoue Makoto, Chikuda Hirotaka

机构信息

a Department of Orthopedic Surgery , Japan Redcross Society Fukaya Redcross Hospital , Fukaya , Saitama , Japan.

b Department of Orthopedic Surgery , Gunma University Graduate School of Medicine , Maebashi , Gunma , Japan.

出版信息

Mod Rheumatol. 2018 May;28(3):468-473. doi: 10.1080/14397595.2017.1362093. Epub 2017 Aug 14.

Abstract

OBJECTIVE

The aim of this study was to compare the efficacy of six-month teriparatide treatment followed by six-month bisphosphonate therapy with 12-month bisphosphonate monotherapy in Japanese rheumatoid arthritis (RA) patients who had not been previously treated for osteoporosis.

METHODS

A total of 34 RA patients with osteoporosis were enrolled. Thirteen patients received six-month teriparatide prior to six-month minodronate therapy (PTH group), and 21 patients received 12-month minodronate therapy (BP group). Bone mineral density (BMD), and bone turnover markers were measured prior to and 6 and 12 months after the initiation of treatment.

RESULTS

Bone mineral density of the spine was significantly increased after 12 months of treatment in both groups. In the PTH group, the mean percent change of BMD of the spine was significantly higher at 12 months after the initiation of treatment, as compared to the BP group (PTH group: 9.9 ± 1.5%, BP group: 5.5 ± 0.7%). Femoral neck BMD was significantly increased only in the PTH group after 12 months.

CONCLUSION

Therapy involving six-month teriparatide followed by six-month minodronate therapy increased spine BMD to a greater degree than 12-month minodronate monotherapy. The strategy of short-term administration of teriparatide for RA patients with osteoporosis might be useful when additional bisphosphonate therapy is considered.

摘要

目的

本研究旨在比较在未曾接受过骨质疏松症治疗的日本类风湿关节炎(RA)患者中,先进行6个月的特立帕肽治疗,随后进行6个月的双膦酸盐治疗与12个月的双膦酸盐单一疗法的疗效。

方法

共纳入34例患有骨质疏松症的RA患者。13例患者在接受6个月的米诺膦酸治疗前先接受6个月的特立帕肽治疗(甲状旁腺激素组),21例患者接受12个月的米诺膦酸治疗(双膦酸盐组)。在治疗开始前以及治疗开始后6个月和12个月测量骨密度(BMD)和骨转换标志物。

结果

两组治疗12个月后脊柱骨密度均显著增加。在甲状旁腺激素组中,治疗开始后12个月时脊柱BMD的平均变化百分比显著高于双膦酸盐组(甲状旁腺激素组:9.9±1.5%,双膦酸盐组:5.5±0.7%)。仅甲状旁腺激素组在12个月后股骨颈骨密度显著增加。

结论

先进行6个月的特立帕肽治疗,随后进行6个月的米诺膦酸治疗,与12个月的米诺膦酸单一疗法相比,能更大程度地增加脊柱骨密度。当考虑额外的双膦酸盐治疗时,对患有骨质疏松症的RA患者短期给予特立帕肽的策略可能是有用的。

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