Okimoto Nobukazu, Arita Shinobu, Akahoshi Shojiro, Baba Kenji, Fukuhara Shito, Ishikura Toru, Yoshioka Toru, Fuse Yoshifumi, Okamoto Ken, Menuki Kunitaka, Sakai Akinori
Okimoto Clinic, Kure, Japan.
Department of Orthopaedic Surgery, Obase Hospital, Miyako-gun, Japan.
Osteoporos Sarcopenia. 2018 Jun;4(2):61-68. doi: 10.1016/j.afos.2018.05.001. Epub 2018 Jul 9.
The purpose of this study was to investigate the influences of interruption and reinitiation of monthly minodronate therapy on the bone mineral density (BMD) and bone metabolism markers in postmenopausal women with osteoporosis.
Study patients were included if they had been administered monthly minodronate therapy for ≥6 months, interrupted the therapy, and reinitiated the therapy for ≥12 months. The BMD and bone metabolism markers were assessed at 4 time points: initiation, interruption, reinitiation and 1 year after reinitiation of therapy.
A total of 23 patients were enrolled. The mean monthly minodronate treatment period was 23.8 ± 12.9 months following a mean interruption period of 11.9 ± 5.4 months. Once increased by monthly minodronate treatment for 2 years on average, the BMD of lumbar spine and radius did not significantly decrease even after an interruption for 1 year on average. However, the BMD of the femoral neck did decrease after interruption. The BMD of the lumbar spine and radius increased further after 1 year of monthly minodronate retreatment. The BMD of the femoral neck did not change. Once decreased after the treatment for an average of 2 years followed by an interruption for 1 year, bone metabolism markers increased gradually but did not recover to baseline levels. A potent suppressive effect on bone resorption was noted. The change rate was greater for the bone formation marker procollagen 1 N-terminal propeptide.
Monthly minodronate treatment increases BMD and reduces bone metabolism markers. The effect lessens after treatment interruptions, and can be restored by retreatment.
本研究旨在探讨每月一次的米诺膦酸治疗中断及重新开始对绝经后骨质疏松症女性骨密度(BMD)和骨代谢标志物的影响。
纳入的研究患者需满足以下条件:接受每月一次的米诺膦酸治疗≥6个月,中断治疗,然后重新开始治疗≥12个月。在4个时间点评估BMD和骨代谢标志物:治疗开始时、中断时、重新开始时以及重新开始治疗1年后。
共纳入23例患者。米诺膦酸平均每月治疗期为23.8±12.9个月,平均中断期为11.9±5.4个月。平均接受每月一次的米诺膦酸治疗2年后,腰椎和桡骨的BMD即使在平均中断1年后也没有显著下降。然而,股骨颈的BMD在中断后确实下降了。重新进行每月一次的米诺膦酸治疗1年后,腰椎和桡骨的BMD进一步增加。股骨颈的BMD没有变化。平均治疗2年后中断1年,骨代谢标志物一度下降,但随后逐渐升高,但未恢复到基线水平。观察到对骨吸收有显著的抑制作用。骨形成标志物1型前胶原N端前肽的变化率更大。
每月一次的米诺膦酸治疗可增加BMD并降低骨代谢标志物。治疗中断后效果减弱,重新治疗可恢复。