Bueno Jose A Hernández, Arias Lizbeth, Yu Ching-Ray, Williams Robert, Komm Barry S
1Naucalpan, Estado de México 2Pfizer Inc., Bosques de las Lomas, Mexico 3Pfizer Inc., New York, NY 4Pfizer Inc., Collegeville, PA.
Menopause. 2017 Sep;24(9):1033-1039. doi: 10.1097/GME.0000000000000889.
Bazedoxifene (BZA) reduces fractures and bone turnover in postmenopausal women with osteoporosis. This report evaluates safety and efficacy of BZA in Latin American women in the global trial.
In the 3-year, phase 3, randomized, double-blind trial, postmenopausal women with osteoporosis (N = 7,492) received BZA 20 or 40 mg/d, raloxifene 60 mg/d, or placebo. Outcomes included vertebral fractures, bone mineral density, bone turnover markers, and safety. This post hoc analysis included 3,036 Latin American women.
Incidence of vertebral fractures at month 36 with BZA 20 mg, BZA 40 mg, raloxifene, and placebo was 1.87%, 1.90%, 1.43%, and 2.83%, respectively (differences not significant). Adjusted mean percentage increases in bone mineral density were 2.49%, 2.79%, 3.18%, and 1.26% for lumbar spine, and 0.40%, 0.95%, 1.11%, and -0.41% for total hip (P < 0.001 for BZA 20/40 mg vs placebo). Adjusted median percentage reductions in osteocalcin at month 12 were -43.0%, -44.1%, -46.9%, and -27.0%, and C-telopeptide were -50.7%, -53.4%, -57.6%, and -32.1% (P < 0.001 for BZA 20/40 mg vs placebo). Common adverse events included pain and flu syndrome.
BZA significantly improved bone mineral density and reduced bone turnover, and numerically reduced fractures, compared with placebo in postmenopausal Latin American women with osteoporosis. Results were similar to the global trial.
巴多昔芬(BZA)可降低绝经后骨质疏松症女性的骨折风险并减少骨转换。本报告评估了在全球试验中BZA对拉丁美洲女性的安全性和有效性。
在这项为期3年的3期随机双盲试验中,绝经后骨质疏松症女性(N = 7492)接受20或40mg/d的BZA、60mg/d的雷洛昔芬或安慰剂。观察指标包括椎体骨折、骨密度、骨转换标志物和安全性。这项事后分析纳入了3036名拉丁美洲女性。
在第36个月时,20mg BZA组、40mg BZA组、雷洛昔芬组和安慰剂组的椎体骨折发生率分别为1.87%、1.90%、1.43%和2.83%(差异无统计学意义)。腰椎骨密度调整后的平均百分比增加值分别为2.49%、2.79%、3.18%和1.26%,全髋分别为0.40%、0.95%、1.11%和 -0.41%(20/40mg BZA与安慰剂相比,P < 0.001)。在第12个月时,骨钙素调整后的中位数百分比降低分别为 -43.0%、-44.1%、-46.9%和 -27.0%,I型胶原C端肽分别为 -50.7%、-53.4%、-57.6%和 -32.1%(20/40mg BZA与安慰剂相比,P < 0.001)。常见不良事件包括疼痛和流感样综合征。
与安慰剂相比,BZA可显著提高绝经后拉丁美洲骨质疏松症女性的骨密度,减少骨转换,并在数值上降低骨折发生率。结果与全球试验相似。