Department of Endocrinology and Metabolism, Kyung Hee University Hospital, Seoul, Republic of Korea.
Department of Endocrinology and Metabolism, The Catholic University of Korea, Seoul ST. Mary's Hospital, Seoul, Republic of Korea.
Arch Osteoporos. 2019 Dec 9;15(1):3. doi: 10.1007/s11657-019-0663-5.
The efficacy of once-weekly risedronate with and without cholecalciferol in bone mineral density (BMD) in Korean patients with osteoporosis was compared. After 12 months, both spine and hip BMD increased significantly in both groups, but there was no significant difference between two groups.
This study investigated the efficacy and safety of once-weekly risedronate with and without cholecalciferol in BMD in Korean patients with osteoporosis.
This was a prospective, 12-month, randomized, open-labeled, actively controlled trial involving 41 hospitals. A total of 841 subjects with osteoporosis were randomized to once-weekly risedronate (35 mg) and cholecalciferol (5600 IU) in a single pill (RSD+, n = 642) or once-weekly risedronate (35 mg) alone (RSD, n = 199). BMD was measured via dual-energy X-ray absorptiometry at the lumbar spine and hip, and the serum levels of 25-hydroxy vitamin D (25(OH) D), parathyroid hormone (PTH), and alkaline phosphatase (ALP) were assayed at baseline and after 12 months of treatment.
After 12 months, the lumbar spine, femoral neck, and total hip BMD increased significantly in both groups; there was no significant difference between two groups. Women in the RSD+ group exhibited significantly increased lumbar spine BMD, and subjects with previous fracture history in the RSD+ group had significantly increased total hip BMD compared with the RSD group. The serum 25(OH) D level increased significantly in the RSD+ group. The serum PTH level decreased in the RSD+ group but increased in the RSD group. The serum ALP level significantly decreased in both groups; there was no significant difference between two groups.
A once-weekly pill containing risedronate and cholecalciferol had the equivalent antiresorptive efficacy on BMD compared with risedronate alone and improved 25(OH) D serum levels after 12 months of treatment without significant adverse events in Korean patients with osteoporosis.
比较每周一次利塞膦酸钠联合或不联合胆钙化醇治疗韩国骨质疏松症患者的骨密度(BMD)的疗效。
这是一项为期 12 个月、前瞻性、随机、开放标签、阳性对照试验,涉及 41 家医院。共纳入 841 例骨质疏松症患者,随机分为每周一次利塞膦酸钠(35mg)联合胆钙化醇(5600IU)单药治疗(RSD+组,n=642)或每周一次利塞膦酸钠(35mg)单药治疗(RSD 组,n=199)。治疗 12 个月后,通过双能 X 射线吸收法测量腰椎和髋部的 BMD,并检测血清 25-羟维生素 D(25(OH)D)、甲状旁腺激素(PTH)和碱性磷酸酶(ALP)水平。
治疗 12 个月后,两组腰椎、股骨颈和全髋 BMD 均显著增加,两组间无显著差异。RSD+组女性腰椎 BMD 显著增加,RSD+组有既往骨折史的患者全髋 BMD 显著增加,而 RSD 组无显著变化。RSD+组血清 25(OH)D 水平显著升高。RSD+组 PTH 水平下降,RSD 组升高。两组血清 ALP 水平均显著降低,两组间无显著差异。
每周一次的利塞膦酸钠联合胆钙化醇片与利塞膦酸钠单药治疗相比,在韩国骨质疏松症患者中具有相当的抗吸收作用,能改善 BMD,并在治疗 12 个月后提高血清 25(OH)D 水平,且无明显不良反应。