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基于给药前血液检测结果的罗莫佐单抗给药后骨密度增加的预测因素。

Predictive Factors for Increased Bone Density Following Romosozumab Administration Based on Pre-Administration Blood Test Results.

作者信息

Kuwabara Akira, Inage Kazuhide, Yamashita Masaomi, Orita Sumihisa, Eguchi Yawara, Shiga Yasuhiro, Inoue Masahiro, Suzuki-Narita Miyako, Hishiya Takahisa, Arai Takahito, Toshi Noriyasu, Okuyama Kohei, Tokeshi Soichiro, Tashiro Susumu, Ohyama Shuhei, Suzuki Noritaka, Ohtori Seiji

机构信息

Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.

Department of Rehabilitation, JCHO Funabashi Central Hospital, Funabashi, Japan.

出版信息

Yonsei Med J. 2025 Apr;66(4):226-232. doi: 10.3349/ymj.2023.0535.

Abstract

PURPOSE

Romosozumab reportedly increases bone density in patients with severe osteoporosis; however, data on its clinical effects are limited. We conducted a multicenter retrospective survey to study the bone density-increasing effects of romosozumab and blood test-based predictive factors in patients with severe osteoporosis, examining its effects in clinical practice.

MATERIALS AND METHODS

This was a multicenter retrospective observational study. The subjects were patients with severe osteoporosis who were treated with romosozumab at the participating facilities. The increase in bone density was assessed by comparing bone density changes (as a percentage) in the lumbar spine, femoral neck, and total femur before and 12 months after administration using dual-energy X-ray absorptiometry. The association between changes in bone density at each site and pre-treatment bone metabolism markers (Tracp 5b, P1NP), serum calcium levels, nutritional status [Conut score: albumin, total cholesterol (T-Cho), and total lymphocyte count], and kidney function (eGFR) was assessed.

RESULTS

In both naïve patients and those switching from bone resorption inhibitors, the bone density increased significantly. In naïve patients, eGFR were positively associated with bone density in the total femur. In cases of switching from bone resorption inhibitors, correlations were found between Tracp 5b and lumbar spine bone mineral density (BMD), as well as between Tracp 5b, Alb, T-Cho, and eGFR in the total femur BMD.

CONCLUSION

Romosozumab administration significantly increases bone density in osteoporosis, and assessing key predictive factors is necessary to ensure clinical effectiveness.

摘要

目的

据报道,罗莫单抗可增加严重骨质疏松症患者的骨密度;然而,其临床效果的数据有限。我们进行了一项多中心回顾性调查,以研究罗莫单抗对严重骨质疏松症患者的骨密度增加作用以及基于血液检测的预测因素,从而在临床实践中检验其效果。

材料与方法

这是一项多中心回顾性观察研究。研究对象为在参与机构接受罗莫单抗治疗的严重骨质疏松症患者。使用双能X线吸收法,通过比较给药前和给药12个月后腰椎、股骨颈和全股骨的骨密度变化(以百分比表示)来评估骨密度的增加情况。评估了每个部位骨密度变化与治疗前骨代谢标志物(抗酒石酸酸性磷酸酶5b、I型前胶原氨基端前肽)、血清钙水平、营养状况[Conut评分:白蛋白、总胆固醇(T-Cho)和总淋巴细胞计数]以及肾功能(估算肾小球滤过率)之间的关联。

结果

在初治患者和从骨吸收抑制剂转换治疗的患者中,骨密度均显著增加。在初治患者中,估算肾小球滤过率与全股骨的骨密度呈正相关。在从骨吸收抑制剂转换治疗的患者中,发现抗酒石酸酸性磷酸酶5b与腰椎骨矿物质密度(BMD)之间存在相关性,以及抗酒石酸酸性磷酸酶5b、白蛋白、总胆固醇和估算肾小球滤过率与全股骨骨密度之间存在相关性。

结论

罗莫单抗给药可显著增加骨质疏松症患者的骨密度,评估关键预测因素对于确保临床疗效是必要的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/57ce/11955392/567d8da204e3/ymj-66-226-g001.jpg

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