Chen Zhipeng, Lin Wei, Zhao Shengli, Mo Xiaoyi, Yuan Weiquan, Cheung Wing Hoi, Fu Dan, Chen Bailing
Department of Spine Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Orthopedics and Traumatology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Department of Orthopaedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.
Ann Palliat Med. 2021 Apr;10(4):4000-4007. doi: 10.21037/apm-20-2333. Epub 2021 Mar 1.
Osteoporotic vertebral compression fracture (OVCF) is a common disease in elderly population, which could cause serious back pain and has a substantial impact on patients' health-related quality of life (HRQoL). The aim of this study was to identify the effect of Teriparatide as a conservative treatment on reducing back pain, and improving quality of life for postmenopausal women with osteoporotic vertebral fractures.
In a 12-month, retrospective study, 112 postmenopausal women with OVCFs were assigned to Teriparatide group (20 µg Teriparatide, subcutaneous, once daily, n=38) or control group (500 mg calcium and 400-800 IU Vitamin D per day, oral administration, n=74) according to patients' choices between January 2016 and October 2018. Patient-reported outcomes scores including the visual analogue score (VAS), Oswestry disability index (ODI), and short form 36 questionnaire (SF-36) were assessed at baseline, the 3rd months, the 6th months and 1 year after treatment.
Treatments with Teriparatide or calcium plus vitamin D supplements had significant effect on improvement of patients' back pain as well as HRQoL, with significantly reduced VAS and ODI and increased SF-36 physical component summary (PCS) and mental component summary (MCS) scores. At the endpoint, Teriparatide showed better therapeutic effect, with greater reductions in VAS and ODI and more increases in SF-36 PCS and MCS scores. However, more adverse events (AEs) were found in Teriparatide group, but symptoms were relatively mild and of short duration.
In postmenopausal women with OVCFs, the consequent persistent back pain and impaired HRQoL, treatment with Teriparatide was associated with more profound therapeutic effects and more AEs compared with calcium plus vitamin D supplements.
骨质疏松性椎体压缩骨折(OVCF)是老年人群中的常见疾病,可导致严重的背痛,并对患者的健康相关生活质量(HRQoL)产生重大影响。本研究的目的是确定特立帕肽作为一种保守治疗方法对减轻绝经后骨质疏松性椎体骨折女性的背痛及改善其生活质量的效果。
在一项为期12个月的回顾性研究中,根据患者的选择,将112例绝经后OVCF女性在2016年1月至2018年10月期间分为特立帕肽组(20μg特立帕肽,皮下注射,每日一次,n = 38)或对照组(每日口服500mg钙和400 - 800IU维生素D,n = 74)。在基线、治疗后第3个月、第6个月和1年时评估患者报告的结局评分,包括视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)和简短健康调查问卷(SF - 36)。
特立帕肽或钙加维生素D补充剂治疗对改善患者的背痛及HRQoL均有显著效果,VAS和ODI显著降低,SF - 36身体成分总结(PCS)和精神成分总结(MCS)评分增加。在终点时,特立帕肽显示出更好的治疗效果,VAS和ODI降低幅度更大,SF - 36 PCS和MCS评分增加更多。然而,特立帕肽组发现更多不良事件(AE),但症状相对较轻且持续时间短。
在绝经后OVCF女性中,对于随之而来的持续性背痛和受损的HRQoL,与钙加维生素D补充剂相比,特立帕肽治疗具有更显著的治疗效果,但不良事件更多。