双膦酸盐和地诺单抗治疗对日本伴腋窝孤立性骨转移的乳腺癌患者骨小梁评分的影响。
Effect of bisphosphonate and denosumab treatment on TBS in Japanese breast cancer patients with AIBL.
作者信息
Onuma Emi, Saito Shin, Tsuburai Taku, Yoshikata Hiromi, Adachi Shoko, Yamamoto Shinya, Narui Kazutaka, Hayama Tomonari, Murase Mariko, Mizushima Taichi, Miyagi Etsuko, Sakakibara Hideya, Asano Ryoko
机构信息
Department of Gynecology, Yokohama City University Medical Center, 4-57 Urafunecho, Minami-ku, Yokohama, Kanagawa, 232-0024, Japan.
Department of Breast Surgery, Yokohama City University Medical Center, 4-57 Urafunecho, Minami-ku, Yokohama, Kanagawa, 232-0024, Japan.
出版信息
J Bone Miner Metab. 2024 Nov;42(6):699-709. doi: 10.1007/s00774-024-01542-2. Epub 2024 Aug 13.
INTRODUCTION
Bisphosphonates and denosumab increase bone mineral density (BMD) for osteoporosis treatment in patients with aromatase inhibitor-associated bone loss (AIBL). This study aimed to directly compare bisphosphonates with denosumab in treating patients with AIBL and to determine the effect of denosumab on the trabecular bone score (TBS).
MATERIALS AND METHODS
Thirty-nine patients with AIBL receiving osteoporosis treatment (21 in the bisphosphonates group and 18 in the denosumab group) were retrospectively evaluated for changes in lumbar spine and femoral BMD, lumbar spine bone quality (assessed by TBS), and blood bone metabolic markers. The Mann-Whitney and Wilcoxon tests were used for statistical evaluation.
RESULTS
After 24 months of treatment, the lumbar spine BMD change rate was 5.82 ± 1.10% with bisphosphonates and 10.49 ± 1.20% with denosumab, with the change rate of denosumab significantly increasing over that of bisphosphonates. The change rate in femoral BMD was 2.69 ± 1.16% with bisphosphonates and 2.95 ± 1.26% with denosumab, with no significant difference between the two groups. The rate of decrease in tartrate-resistant acid phosphatase isoform 5b was significantly higher in the denosumab group. The change rate in TBS at 24 months of treatment was 0.53 ± 1.26% in the bisphosphonates group and 1.08 ± 1.33% in the denosumab group, with no significant difference between the two groups. After 24 months, TBS remained stable.
CONCLUSION
Both bisphosphonates and denosumab may increase BMD, improve bone metabolism, and inhibit bone quality loss in patients with AIBL.
引言
双膦酸盐和地诺单抗可提高骨密度（BMD），用于治疗芳香化酶抑制剂相关骨质流失（AIBL）的骨质疏松症患者。本研究旨在直接比较双膦酸盐和地诺单抗治疗AIBL患者的效果，并确定地诺单抗对小梁骨评分（TBS）的影响。
材料与方法
回顾性评估39例接受骨质疏松症治疗的AIBL患者（双膦酸盐组21例，地诺单抗组18例）腰椎和股骨骨密度、腰椎骨质量（通过TBS评估）及血骨代谢标志物的变化。采用Mann-Whitney和Wilcoxon检验进行统计学评估。
结果
治疗24个月后，双膦酸盐组腰椎骨密度变化率为5.82±1.10%，地诺单抗组为10.49±1.20%，地诺单抗组的变化率显著高于双膦酸盐组。双膦酸盐组股骨骨密度变化率为2.69±1.16%，地诺单抗组为2.95±1.26%，两组间无显著差异。地诺单抗组抗酒石酸酸性磷酸酶同工型5b的下降率显著更高。治疗24个月时，双膦酸盐组TBS变化率为0.53±1.26%，地诺单抗组为1.08±1.33%，两组间无显著差异。24个月后，TBS保持稳定。
结论
双膦酸盐和地诺单抗均可提高AIBL患者的骨密度，改善骨代谢，抑制骨质流失。
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