Chin Michelle, Hill Ronald, Huber Bryan, Howe James, Engelke Klaus
AgNovos Healthcare, Rockville, MD 20855, USA.
Department of Medical Physics (IMP), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Henkestr. 91, 91052, Erlangen, Germany.
JBMR Plus. 2025 Apr 4;9(5):ziaf036. doi: 10.1093/jbmrpl/ziaf036. eCollection 2025 May.
In this study, QCT was used to analyze the AGN1 Local Osteo-Enhancement Procedure (LOEP) as a treatment to form bone in the proximal femurs of patients with osteoporosis. Using this minimally invasive procedure, a resorbable triphasic AGN1 implant material was injected into the left femurs of 12 women with post-menopausal osteoporosis. Computed tomography scans were taken before treatment (baseline) and at 12 wk, 24 wk, and 5-7 yr after treatment. Quantitative computed tomography was used to investigate the resorption of AGN1 within the treated proximal femurs and to analyze the treatment's impact on integral, trabecular, and cortical bone. The untreated right femurs were used as controls. Data illustrated an increase in trabecular volumetric BMD (trab vBMD) of treated hips at all timepoints (baseline: 22 ± 21 mg/cm vs 217 ± 56 mg/cm, 161 ± 18 mg/cm, and 121 ± 37 mg/cm at 12-wk, 24-wk, and 5- to 7-yr timepoints, respectively), and an increase in integral vBMD of 65% at the 12-wk timepoint and 34% at the 5- to 7-yr timepoint. The increase in trab vBMD was observed in the location where the AGN1 implant material bolus was injected, and at the 5- to 7-yr timepoint, no significant BMD change was observed in the trabecular regions surrounding the original implantation zone (treated: 32 ± 16 mg/cm, control: 31 ± 16 mg/cm). This QCT study provides a more detailed understanding of the resorption and transformation of the AGN1 implant material into bone and supports, with some limitations, that the AGN1 LOEP treatment can locally increase trabecular bone density in weakened areas of the proximal femur where strength increase is most needed to reduce the risk of hip fragility fracture.
在本研究中,定量计算机断层扫描(QCT)被用于分析AGN1局部骨增强程序(LOEP)作为一种在骨质疏松症患者股骨近端形成骨组织的治疗方法。采用这种微创手术,将一种可吸收的三相AGN1植入材料注入12名绝经后骨质疏松症女性的左侧股骨。在治疗前(基线)以及治疗后12周、24周和5至7年进行计算机断层扫描。定量计算机断层扫描用于研究治疗后的股骨近端内AGN1的吸收情况,并分析该治疗对整体骨、小梁骨和皮质骨的影响。未治疗的右侧股骨用作对照。数据表明,在所有时间点,治疗侧髋部的小梁骨体积骨密度(trab vBMD)均增加(基线时为22±21mg/cm,在12周、24周以及5至7年时间点分别为217±56mg/cm、161±18mg/cm和121±37mg/cm),在12周时间点整体骨体积骨密度增加65%,在5至7年时间点增加34%。在注入AGN1植入材料团块的位置观察到trab vBMD增加,并且在5至7年时间点,在原始植入区域周围的小梁区域未观察到明显的骨密度变化(治疗侧:32±16mg/cm,对照侧:31±16mg/cm)。这项QCT研究提供了对AGN1植入材料吸收并转化为骨组织的更详细理解,并在一定程度上支持了AGN1 LOEP治疗可以局部增加股骨近端薄弱区域的小梁骨密度,而这些区域最需要增加强度以降低髋部脆性骨折风险。