Zhu Yilin, Huang Zhonglian, Wang Yan, Xu Weicai, Chen Hongjiang, Xu Jiankun, Luo Shaowei, Zhang Yuantao, Zhao Di, Hu Jun
Department of Orthopaedics, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China.
Department of Orthopaedics and Traumatology, Beijing Jishuitan Hospital, Beijing, 100035, China.
J Orthop Translat. 2019 Sep 9;22:7-13. doi: 10.1016/j.jot.2019.08.004. eCollection 2020 May.
The objective of this study was to assess the efficacy and safety of denosumab therapy in osteoporotic postmenopausal women who were previously treated with bisphosphonates.
Meta-analyses of four available randomised controlled trials that compared osteoporotic patients who switched to denosumab from bisphosphonates (n = 1416) and those who continued bisphosphonates therapy (n = 1411) were included.
The increase in bone mineral density (BMD) of both the spine and hip was significantly higher in patients who shifted to denosumab than in those who continued bisphosphonates. Despite the incidence of adverse events (AEs) and fractures being comparable, treatment withdrawal owing to AEs was significantly less frequent in the denosumab group.
The outcomes and treatment compliance were improved in postmenopausal osteoporotic women who shifted to denosumab from bisphosphonates.
The replacement of bisphosphonates with denosumab may lead to better therapeutic efficacy and fewer adherence barriers than those with continued usage of bisphosphonates, which in the future may guide the choice of drug therapy in clinics.
本研究的目的是评估地诺单抗治疗对既往接受过双膦酸盐治疗的绝经后骨质疏松症女性的疗效和安全性。
纳入四项现有随机对照试验的荟萃分析，这些试验比较了从双膦酸盐转换为地诺单抗的骨质疏松症患者（n = 1416）和继续接受双膦酸盐治疗的患者（n = 1411）。
转换为地诺单抗的患者脊柱和髋部的骨密度（BMD）增加显著高于继续使用双膦酸盐的患者。尽管不良事件（AE）和骨折的发生率相当，但地诺单抗组因AE导致的治疗停药明显较少。
从双膦酸盐转换为地诺单抗的绝经后骨质疏松症女性的治疗效果和治疗依从性得到改善。
与继续使用双膦酸盐相比，用地诺单抗替代双膦酸盐可能会带来更好的治疗效果和更少的依从性障碍，这在未来可能会指导临床药物治疗的选择。
