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伊班膦酸钠治疗绝经后日本原发性骨质疏松症女性3年的疗效、安全性及依从性

Efficacy, safety, and compliance of ibandronate treatment for 3 years in postmenopausal Japanese women with primary osteoporosis.

作者信息

Suzuki Takako, Nakamura Yukio, Kato Hiroyuki

机构信息

Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Nagano, Japan.

Department of Orthopedic Surgery, Showa-Inan General Hospital, Komagane, Nagano, Japan.

出版信息

Osteoporos Sarcopenia. 2018 Jun;4(2):69-72. doi: 10.1016/j.afos.2018.04.001. Epub 2018 Apr 27.

Abstract

OBJECTIVES

The aim of this study was to examine the efficacy, safety, and adherence of ibandronate (IBN) treatment with or without vitamin D supplementation for 3 years in Japanese women with postmenopausal osteoporosis.

METHODS

This prospective investigation included 27 patients treated with IBN alone (monotherapy group) and 29 patients receiving IBN and alfacalcidol (ALF) (combination group). Bone metabolism and bone mineral density (BMD) were measured before and at 18, 24, 30, and 36 months of therapy. Treatment discontinuation and fracture occurrence were assessed as well.

RESULTS

Lumbar 1-4 BMD (L-BMD) was significantly increased in the monotherapy and combination groups by 3.9% and 7.2%, respectively, at 36 months, with significant gains in total hip BMD (H-BMD) of 3.7% and 4.9%, respectively. There were significant differences in L-BMD improvement between the groups at 18, 24, and 30 months (P < 0.05) and at 36 months (P < 0.01). Compared with pretreatment levels, the percentage changes of L-BMD and H-BMD were significant at all time points in the combination group and at all points apart from L-BMD at 36 months in the monotherapy group. In the monotherapy group, 14 patients dropped out during 3 years and 2 vertebral fractures occurred during the first year. In the combination group, 16 cases dropped out during 3 years and 1 nonvertebral fracture was noted during the first year.

CONCLUSIONS

Our findings suggest that combination therapy of IBN and vitamin D is superior to monotherapy with regard to L-BMD improvements for 3 years, with both groups showing comparable safety and adherence to treatment.

摘要

目的

本研究旨在探讨在日本绝经后骨质疏松症女性中,使用或不使用维生素D补充剂的伊班膦酸钠(IBN)治疗3年的疗效、安全性和依从性。

方法

这项前瞻性研究纳入了27例单独接受IBN治疗的患者(单药治疗组)和29例接受IBN与阿法骨化醇(ALF)联合治疗的患者(联合治疗组)。在治疗前以及治疗18、24、30和36个月时测量骨代谢和骨密度(BMD)。同时评估治疗中断情况和骨折发生情况。

结果

单药治疗组和联合治疗组的第1-4腰椎骨密度(L-BMD)在36个月时分别显著增加了3.9%和7.2%,全髋骨密度(H-BMD)分别显著增加了3.7%和4.9%。两组在18、24和30个月时以及36个月时L-BMD改善情况存在显著差异(P<0.05)和(P<0.01)。与治疗前水平相比,联合治疗组在所有时间点L-BMD和H-BMD的百分比变化均显著,单药治疗组除36个月时L-BMD外的所有时间点变化均显著。在单药治疗组中,14例患者在3年内退出,2例椎体骨折发生在第一年。在联合治疗组中,16例患者在3年内退出,1例非椎体骨折发生在第一年。

结论

我们的研究结果表明,IBN与维生素D联合治疗在3年L-BMD改善方面优于单药治疗,两组在安全性和治疗依从性方面相当。

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