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利塞膦酸盐治疗骨Paget病的安全性和有效性:日本上市后监测研究

Safety and effectiveness of risedronate in Paget's disease of bone: postmarketing surveillance study in Japan.

作者信息

Hashimoto Jun, Arai Yuki, Kurosu Shinsuke, Ikezaki Toshimi

机构信息

National Hospital Organization Osaka Minami Medical Center, 2-1, Kido Higashimachi, Kawachinagano, Osaka, 586-8521, Japan.

Medical Department, EA Pharma Co., Ltd., 2-1-1, Irifune, Chuo-ku, Tokyo, 104-0042, Japan.

出版信息

J Bone Miner Metab. 2024 Jan;42(1):122-133. doi: 10.1007/s00774-023-01486-z. Epub 2024 Jan 10.

Abstract

INTRODUCTION

We conducted an all-case postmarketing surveillance study between 2008 and 2017 to evaluate the safety and effectiveness of risedronate for Paget's disease of bone (PDB) in Japan.

MATERIAL AND METHODS

This study registered all patients who received once-daily risedronate 17.5 mg for the treatment of PDB and collected data over a 48-week follow-up period per treatment cycle for each patient.

RESULTS

The safety analysis set included 184 patients (mean age, 63.7 years), 81 (44.0%) of whom previously received a bisphosphonate. Of them, 41 (22.3%) experienced 72 adverse drug reactions (ADRs), and 8 (4.3%) experienced 14 serious ADRs. Common ADRs included gastrointestinal disorders (20 patients, 10.9%) and hypocalcemia (6 patients, 3.3%). The effectiveness analysis set included 182 patients, 124 of whom completed only one treatment cycle and 58 of whom completed multiple treatment cycles. The proportions of patients who normalized serum alkaline phosphatase (ALP) concentration were 71.1% (113/159 patients) and 67.3% (33/49 patients) for the first and second treatment cycles, respectively. The relapse rate according to ALP levels after the end of treatment for the first cycle was 5.0% (95% confidence interval [CI] = 2.1-11.5) at 24 weeks and 12.9% (95% CI = 7.5-21.7) at 40 weeks. Regarding pain relief, the achievement rates were 70.0% (49/70 patients) and 30.8% (4/13 patients) for the first and second treatment cycles, respectively.

CONCLUSION

To conclude, risedronate 17.5 mg/day is safe and effective for treating patients with PDB in daily practice.

摘要

引言

我们在2008年至2017年期间开展了一项全病例上市后监测研究,以评估利塞膦酸钠治疗日本骨Paget病(PDB)的安全性和有效性。

材料与方法

本研究纳入了所有接受每日一次17.5毫克利塞膦酸钠治疗PDB的患者,并在每个患者的每个治疗周期的48周随访期内收集数据。

结果

安全性分析集包括184例患者(平均年龄63.7岁),其中81例(44.0%)曾接受过双膦酸盐治疗。其中,41例(22.3%)发生72例药物不良反应(ADR),8例(4.3%)发生14例严重ADR。常见的ADR包括胃肠道疾病(20例患者,10.9%)和低钙血症(6例患者,3.3%)。有效性分析集包括182例患者,其中124例仅完成一个治疗周期,58例完成多个治疗周期。在第一个和第二个治疗周期中,血清碱性磷酸酶(ALP)浓度恢复正常的患者比例分别为71.1%(113/159例患者)和67.3%(33/49例患者)。在第一个周期治疗结束后,根据ALP水平计算的复发率在24周时为5.0%(95%置信区间[CI]=2.1-11.5),在40周时为12.9%(95%CI=7.5-21.7)。关于疼痛缓解,在第一个和第二个治疗周期中的达标率分别为70.0%(49/70例患者)和30.8%(4/13例患者)。

结论

总之,每日17.5毫克利塞膦酸钠在日常实践中治疗PDB患者是安全有效的。

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