Kumaki Daiki, Nakamura Yukio, Suzuki Takako, Kato Hiroyuki
Department of Orthopaedic Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto 390-8621, Japan.
Department of Orthopaedic Surgery, Showa Inan General Hospital, Akaho 3230, Komagane 399-4117, Japan.
J Clin Med. 2018 Mar 22;7(4):63. doi: 10.3390/jcm7040063.
Adult-onset Still's disease (AOSD) is an autoimmune inflammatory disorder. Glucocorticoids are often used for AOSD, which may induce complicating glucocorticoid-induced osteoporosis (GIO). An anti-resorption drug, denosumab, has recently been approved for osteoporosis treatment in Japan. However, the drug's efficacy for GIO in AOSD is largely unknown. This retrospective, consecutive case series investigated two patients with GIO in AOSD to examine the effects of denosumab on bone metabolism. Bone turnover markers, and bone mineral density (BMD) of the lumbar 1-4 spine (L-BMD) and bilateral total hips (H-BMD) were followed for six months in a male patient and for twelve months in a female patient. No fractures or severe side effects, such as hypocalcemia, were observed during the observational period. Bone turnover markers were basically suppressed, and L-BMD and H-BMD were increased by denosumab in both patients. Our findings suggest that denosumab is a suitable candidate drug for GIO in AOSD.
成人斯蒂尔病（AOSD）是一种自身免疫性炎症性疾病。糖皮质激素常用于治疗AOSD，这可能会引发糖皮质激素诱导的骨质疏松症（GIO）这一并发症。一种抗骨吸收药物地诺单抗最近在日本被批准用于骨质疏松症治疗。然而，该药物对AOSD患者GIO的疗效在很大程度上尚不清楚。本回顾性连续病例系列研究了两名AOSD合并GIO的患者，以考察地诺单抗对骨代谢的影响。对一名男性患者随访6个月，对一名女性患者随访12个月，观察其骨转换标志物以及第1 - 4腰椎（L - BMD）和双侧全髋部（H - BMD）的骨密度。在观察期内未观察到骨折或严重副作用，如低钙血症。两名患者的骨转换标志物基本均受到抑制，地诺单抗使L - BMD和H - BMD均有所增加。我们的研究结果表明，地诺单抗是治疗AOSD患者GIO的合适候选药物。
