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在真实世界中每月静脉注射伊班膦酸钠的有效性:一项上市后观察性研究的亚组分析。

Effectiveness of monthly intravenous ibandronate injections in a real-world setting: Subgroup analysis of a postmarketing observational study.

作者信息

Takeuchi Yasuhiro, Hashimoto Junko, Kakihata Hiroyuki, Nishida Yousuke, Kumagai Michiko, Yamagiwa Chiemi

机构信息

Endocrine Center, Toranomon Hospital and Okinaka Memorial Institute for Medical Research, Tokyo, Japan.

Project & Lifecycle Management Unit, Chugai Pharmaceutical Co., Ltd., Tokyo, Japan.

出版信息

Osteoporos Sarcopenia. 2019 Mar;5(1):11-18. doi: 10.1016/j.afos.2019.02.002. Epub 2019 Mar 14.

Abstract

OBJECTIVES

The favorable safety and consistent effectiveness of monthly intravenous (IV) ibandronate injections was demonstrated in a prospective, postmarketing, observational study in Japanese patients with osteoporosis. Here, we present subgroup analyses from the study.

METHODS

Lumbar spine (L2-4) bone mineral density (BMD) gains were assessed in the following subgroups: aged <75 or ≥75 years, absence or presence of vertebral fractures, previous bisphosphonate (BP) treatment, and concomitant versus naïve osteoporosis drug treatment. The cumulative incidence of fractures and relative change in bone turnover markers were also examined.

RESULTS

Of 1062 enrolled patients, 1025 received monthly IV ibandronate 1 mg and were assessed for 12 months. BMD gains with ibandronate were comparable, irrespective of older age or prevalent fractures. Overall, 515 patients (50.2%) had previously received osteoporosis treatment; of these, 166 (16.1%) received other BPs. Mean BMD changes were 3.69% (95% confidence interval [CI], 0.89%-6.50%) in patients previously treated with other BPs, and 4.26% (95% CI, 2.88%-5.64%) in patients who had not received prior osteoporosis treatment. Among the 510 patients (49.7%) concomitantly prescribed active vitamin D drugs, mean BMD changes were 5.74% (95% CI, 2.53%-8.95%) with eldecalcitol versus 3.54% (95% CI, 1.98%-5.10%) with ibandronate alone. The lowest fracture incidence was observed with the combination of ibandronate and eldecalcitol, but differences between the subgroups were not statistically significant.

CONCLUSIONS

Monthly IV ibandronate demonstrated comparable BMD gains in the patient subgroups analyzed. Concomitant use of ibandronate with eldecalcitol showed a trend of higher BMD gains and lower fracture incidence than ibandronate alone.

摘要

目的

在一项针对日本骨质疏松症患者的前瞻性上市后观察性研究中,证实了每月静脉注射依班膦酸钠的良好安全性和持续有效性。在此,我们展示该研究的亚组分析结果。

方法

在以下亚组中评估腰椎(L2 - 4)骨密度(BMD)的增加情况:年龄<75岁或≥75岁、有无椎体骨折、既往是否接受过双膦酸盐(BP)治疗,以及同时使用与未使用骨质疏松症药物治疗。还检查了骨折的累积发生率和骨转换标志物的相对变化。

结果

在1062名入组患者中,1025名接受了每月1毫克静脉注射依班膦酸钠治疗,并接受了12个月的评估。无论年龄较大或存在既往骨折情况,依班膦酸钠治疗后的BMD增加情况相当。总体而言,515名患者(50.2%)此前接受过骨质疏松症治疗;其中,166名(16.1%)接受过其他双膦酸盐治疗。既往接受过其他双膦酸盐治疗的患者,平均BMD变化为3.69%(95%置信区间[CI],0.89% - 6.50%),未接受过既往骨质疏松症治疗的患者为4.26%(95% CI,2.88% - 5.64%)。在510名(49.7%)同时使用活性维生素D药物的患者中,与阿法骨化醇联合使用时依班膦酸钠的平均BMD变化为5.74%(95% CI,2.53% - 8.95%),单独使用依班膦酸钠时为3.54%(95% CI,1.98% - 5.10%)。依班膦酸钠与阿法骨化醇联合使用时骨折发生率最低,但各亚组之间的差异无统计学意义。

结论

在分析的患者亚组中,每月静脉注射依班膦酸钠显示出相当的BMD增加。依班膦酸钠与阿法骨化醇联合使用较单独使用依班膦酸钠显示出BMD增加更高和骨折发生率更低的趋势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/604a/6452926/7572074f3aef/gr1.jpg

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