Zidrou Christiana, Rizou Stavroula, Beletsiotis Anastasios
2nd Orthopedic Department, General Hospital of Thessaloniki "Papageorgiou", Thessaloniki, GRC.
Medicine Department, National and Kapodistrian University of Athens School of Medicine, Athens, GRC.
Cureus. 2022 Dec 25;14(12):e32923. doi: 10.7759/cureus.32923. eCollection 2022 Dec.
Introduction Bisphosphonates are considered to be the treatment of choice for patients with active Paget's disease. The aim of this study was to record and assess the therapeutic effect in response to a single intravenous infusion of 5mg zoledronic acid or oral risedronate. Methods A retrospective observational study was conducted of 89 patients in Greek patients with active Paget's disease from a tertiary hospital in North Greece. Patients were treated with either a single intravenous infusion of 5mg zoledronic acid (1st group, n=46) or 30mg of risedronate per day for 60 days (2nd group, n=43). All patients received 1000mg of calcium and 400-800IU of calciferol daily. The primary outcome measure was to record the therapeutic response defined as the control of patients' symptoms and normalization of the biochemical markers of bone metabolism. The secondary outcome measures included the patient's quality of life which was evaluated by the questionnaire SF-36 and adverse events. Results Forty patients from the zoledronic acid group and 38 patients from the risedronate group, who reported pain at the beginning of the study, showed a significant degree of clinical improvement. All the patients in our study showed a therapeutic response at six months while the remission was persistent at 36 months. There was a statistically significant difference between pre-treatment basal results and values at the sixth and 36th months of treatment (p<0.001) between the two groups. Conclusion The study demonstrated the superiority of zoledronic acid over risedronate in patients with active Paget's disease.
引言 双膦酸盐被认为是治疗活动期佩吉特病患者的首选药物。本研究的目的是记录和评估单次静脉输注5mg唑来膦酸或口服利塞膦酸钠的治疗效果。方法 对希腊北部一家三级医院的89例患有活动期佩吉特病的希腊患者进行了一项回顾性观察研究。患者接受单次静脉输注5mg唑来膦酸（第1组，n = 46）或每天30mg利塞膦酸钠，持续60天（第2组，n = 43）。所有患者每天接受1000mg钙和400 - 800IU维生素D。主要观察指标是记录治疗反应，定义为控制患者症状和使骨代谢生化标志物正常化。次要观察指标包括通过SF - 36问卷评估的患者生活质量和不良事件。结果 唑来膦酸组的40例患者和利塞膦酸钠组的38例患者在研究开始时报告有疼痛，显示出显著的临床改善。我们研究中的所有患者在6个月时均显示出治疗反应，且缓解在36个月时持续存在。两组治疗前基础结果与治疗第6个月和第36个月的值之间存在统计学显著差异（p < 0.001）。结论 该研究证明了在活动期佩吉特病患者中唑来膦酸比利塞膦酸钠更具优势。
