School of Health Science, Tottori University Faculty of Medicine, 86 Nishi-cho, Yonago, Tottori, 683-8503, Japan.
Department of Orthopaedic Surgery and Rheumatology, Kindai University Nara Hospital, 1248-1 Otoda-cho, Ikoma, Nara, 630-0293, Japan.
J Bone Miner Metab. 2019 Mar;37(2):273-281. doi: 10.1007/s00774-018-0914-3. Epub 2018 Mar 9.
We investigated changes in quality of life (QOL), including pain, in Japanese women aged ≥ 55 years who were diagnosed as having osteoporosis at 265 centers across Japan and treated continuously with once-weekly bisphosphonates for 24 months. In 2650 evaluable patients, a significant improvement in QOL was observed from 3 months after enrollment onward and maintained throughout the 2-year observation period. A significant improvement in scores was observed for all domains of the Euro QOL 5 Dimension (EQ-5D), and the "pain", "health perception", and "posture, figure" domains of the Japanese Osteoporosis QOL Questionnaire (JOQOL). Factors identified as significantly contributing to QOL change were "fractures within the year before enrollment", "presence of spondylosis deformans", "presence of osteoarthritis", "use of activated vitamin D", and "age" based on the JOQOL, and "presence of spondylosis deformans", "use of activated vitamin D", and "age" based on the EQ-5D. The results suggested that the patients' perception of treatment effects, such as improvement in pain, contributes to treatment continuation. Osteoporosis patients should be informed that continuous treatment with once-weekly bisphosphonates can lead to a significant improvement in QOL regardless of concomitant locomotor diseases, to encourage them to remain on treatment. In conclusion, continuous bisphosphonate treatment improved the QOL even in patients with locomotor diseases, and the concomitant use of activated vitamin D may also facilitate further improvement in QOL.
我们研究了日本 265 家中心≥55 岁骨质疏松女性患者的生活质量(QOL)变化,包括疼痛,这些患者被诊断为骨质疏松症,并持续接受每周一次的双膦酸盐治疗 24 个月。在 2650 名可评估患者中,从入组后 3 个月开始,QOL 显著改善,并在 2 年观察期内保持稳定。Euro QOL 5 维度(EQ-5D)的所有领域以及日本骨质疏松症 QOL 问卷(JOQOL)的“疼痛”、“健康感知”和“姿势、体型”领域的评分均显著改善。根据 JOQOL,确定对 QOL 变化有显著贡献的因素为“入组前一年内骨折”、“存在变形性脊柱炎”、“存在骨关节炎”、“使用活性维生素 D”和“年龄”,而根据 EQ-5D,为“存在变形性脊柱炎”、“使用活性维生素 D”和“年龄”。结果表明,患者对治疗效果的感知,如疼痛改善,有助于治疗的持续。应告知骨质疏松症患者,持续接受每周一次的双膦酸盐治疗可显著改善 QOL,无论是否存在运动障碍疾病,以鼓励他们继续治疗。总之,连续的双膦酸盐治疗可改善生活质量,即使在存在运动障碍疾病的患者中,同时使用活性维生素 D 也可能进一步改善生活质量。