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患者背景因素对每周一次特立帕肽治疗疗效的影响。

Impact of patient background factors on the treatment efficacy of once-weekly teriparatide.

作者信息

Omura Fumitoshi

机构信息

Koenji Orthopedics Clinic, Tokyo, Japan.

出版信息

Osteoporos Sarcopenia. 2019 Jun;5(2):51-56. doi: 10.1016/j.afos.2019.04.001. Epub 2019 May 16.

Abstract

OBJECTIVES

The impact of patient background factors on changes in bone mineral density (BMD) and bone metabolic markers after treatment with once-weekly teriparatide (W-TPTD) has not been fully elucidated. To clarify the impact, I performed stratified analysis in addition to the efficacy and safety assessments to analyze treatment data with W-TPTD.

METHODS

The primary endpoint of the efficacy was the rate of change of the lumbar spine BMD at 18 months after treatment. In the exploratory analysis, bone metabolic markers at baseline were used to divide the patients into 3 groups, by the first tertile and the second tertile. The rate of change in the lumbar spine/femoral neck BMD and bone metabolic markers in each group were analyzed by stratification.

RESULTS

The rate of change in the lumbar spine BMD at 18 months was 9.0%, which represented a significant increase. The rate of change in the lumbar spine/femoral neck BMD in each group classified into tertiles by their baseline bone metabolic markers significantly increased, regardless of the type of bone metabolic markers and baseline value. For markers, all groups remained within the range of reference values at 18 months after treatment.

CONCLUSIONS

I demonstrated that W-TPTD significantly increased the BMD of the lumbar spine and femur, regardless of baseline values of the bone metabolic markers. In addition, W-TPTD was able to normalize bone metabolic markers. I considered that W-TPTD would be useful, independent of bone metabolic markers in patients, as an agent to improve BMD, and be a useful option for the treatment of osteoporosis.

摘要

目的

患者背景因素对每周一次使用特立帕肽(W-TPTD)治疗后骨密度(BMD)和骨代谢标志物变化的影响尚未完全阐明。为明确该影响,我在进行疗效和安全性评估的同时进行了分层分析,以分析W-TPTD的治疗数据。

方法

疗效的主要终点是治疗后18个月腰椎BMD的变化率。在探索性分析中,使用基线时的骨代谢标志物将患者按第一个三分位数和第二个三分位数分为3组。通过分层分析每组腰椎/股骨颈BMD和骨代谢标志物的变化率。

结果

18个月时腰椎BMD的变化率为9.0%,显示出显著增加。根据基线骨代谢标志物分为三分位数的每组中,腰椎/股骨颈BMD的变化率均显著增加,无论骨代谢标志物的类型和基线值如何。对于标志物,治疗后18个月时所有组均保持在参考值范围内。

结论

我证明了无论骨代谢标志物的基线值如何,W-TPTD均能显著增加腰椎和股骨的BMD。此外,W-TPTD能够使骨代谢标志物恢复正常。我认为W-TPTD作为一种改善BMD的药物,在患者中独立于骨代谢标志物将是有用的,并且是治疗骨质疏松症的一个有用选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb4c/6626838/a23f73b8d7b5/gr1.jpg

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