New York Presbyterian Weill Cornell Medical College, New York, NY, USA.
Weill Cornell Medicine, New York, NY, USA.
Osteoporos Int. 2024 Nov;35(11):2061-2068. doi: 10.1007/s00198-024-07243-w. Epub 2024 Sep 17.
Osteoporosis is a metabolic bone disorder for which treatment options include antiresorptive therapies (e.g., bisphosphonates, denosumab); anabolics (e.g., teriparatide, abaloparatide); and dual mechanisms (e.g., romosozumab). Management of osteoporosis with concurrent antiresorptive and anabolic agents may be superior to monotherapy, as demonstrated in the DATA trial with the combination of denosumab and teriparatide. However, there is limited experience with the combination of denosumab and romosozumab, which may be an alternative antiresorptive/anabolic regimen for individuals who are not candidates for PTH receptor agonists. In this case, we present a young man with glucocorticoid-induced osteoporosis who could not tolerate a daily injectable anabolic and who experienced improvement in bone mineral density with concurrent denosumab and off-label romosozumab administration.
骨质疏松症是一种代谢性骨病，其治疗选择包括抗吸收疗法（如双磷酸盐类、地舒单抗）；合成代谢药物（如特立帕肽、abaloparatide）；以及双重作用机制药物（如罗莫佐单抗）。在 DATA 试验中，使用地舒单抗和特立帕肽联合治疗骨质疏松症的效果优于单药治疗，这表明联合使用抗吸收和合成代谢药物治疗可能优于单药治疗。然而，关于地舒单抗和罗莫佐单抗联合使用的经验有限，对于不能使用甲状旁腺激素受体激动剂的患者，这种联合用药可能是一种替代抗吸收/合成代谢方案。在这种情况下，我们报告了一例因糖皮质激素引起的骨质疏松症的年轻男性，他不能耐受每日注射的合成代谢药物，而联合使用地舒单抗和非适应证罗莫佐单抗治疗后骨密度得到了改善。
