Zou San-Bao, Zeng Zhen-Hua
Department of Pain, Zhejiang Jiashan County First People's Hospital Jiashan County, Jiaxing 314100, Zhejiang, China.
Am J Transl Res. 2024 Jul 15;16(7):3395-3404. doi: 10.62347/YDKM2312. eCollection 2024.
To explore the efficacy and safety of tibolone combined with zoledronic acid in the treatment of postmenopausal osteoporosis (PMO).
We conducted a retrospective analysis of 121 PMO patients from March 2019 to July 2021. Patients were divided into two groups based on treatment regimen: an observation group (n=62) receiving zoledronic acid combined with tibolone and a control group (n=59) receiving tibolone monotherapy. We evaluated and compared therapeutic efficacy, bone mineral density, bone metabolism markers (osteocalcin, serum C-terminal telopeptide of type I collagen, and bone alkaline phosphatase), pain, knee joint function, incidence of fragility fractures, and adverse reactions. Logistic regression analysis was used to evaluate risk factors affecting treatment efficacy.
The observation group showed a significantly higher therapeutic effect (96.77%) compared to the control group (83.05%), and a lower incidence of fragility fractures (P=0.012). Before treatment, there were no significant differences in bone mineral density, bone metabolism markers, pain status, or knee function between the two groups (all P>0.05). However, after treatment, evaluations showed marked improvements in these parameters in both groups, with more significant enhancements observed in the observation group (all P<0.001). The incidence of adverse reactions did not significantly differ between the groups (20.97% vs 13.56%, P=0.282). Logistic regression analysis identified the use of tibolone combined with zoledronic acid as a protective factor for effective treatment.
Tibolone combined with zoledronic acid significantly increases bone mineral density, improves bone metabolism, and reduces pain in PMO patients, with a safety profile comparable to that of monotherapy. This regimen should be considered for clinical use in treating PMO.
探讨替勃龙联合唑来膦酸治疗绝经后骨质疏松症（PMO）的疗效及安全性。
对2019年3月至2021年7月的121例PMO患者进行回顾性分析。根据治疗方案将患者分为两组：观察组（n = 62）接受唑来膦酸联合替勃龙治疗，对照组（n = 59）接受替勃龙单药治疗。我们评估并比较了治疗效果、骨密度、骨代谢标志物（骨钙素、血清I型胶原C末端肽和骨碱性磷酸酶）、疼痛、膝关节功能、脆性骨折发生率及不良反应。采用Logistic回归分析评估影响治疗效果的危险因素。
观察组的治疗效果（96.77%）显著高于对照组（83.05%），且脆性骨折发生率较低（P = 0.012）。治疗前，两组患者的骨密度、骨代谢标志物、疼痛状况或膝关节功能无显著差异（均P>0.05）。然而，治疗后，两组这些参数均有明显改善，观察组改善更显著（均P<0.001）。两组不良反应发生率无显著差异（20.97%对13.56%，P = 0.282）。Logistic回归分析确定替勃龙联合唑来膦酸的使用是有效治疗的保护因素。
替勃龙联合唑来膦酸可显著提高PMO患者的骨密度，改善骨代谢，减轻疼痛，并具有与单药治疗相当的安全性。该治疗方案应考虑用于PMO的临床治疗。
