Tominaga Ayako, Wada Keiji, Kato Yoshiharu, Okazaki Ken
Department of Orthopedic Surgery, Tokyo Women's Medical University, Tokyo, 162-8666, Japan.
Spine Center, Tomei Atsugi Hospital, Atsugi, Kanagawa, 243-8571, Japan.
JBMR Plus. 2025 Apr 14;9(6):ziaf049. doi: 10.1093/jbmrpl/ziaf049. eCollection 2025 Jun.
Recipients of kidney grafts often develop severe osteoporosis. However, no consensus has emerged on the most appropriate medications for managing osteoporosis in these recipients. In this study, we investigated the efficacy of romosozumab as an additional treatment option for managing severe osteoporosis in kidney transplant recipients (KTRs). Our retrospective observational study included 12 such recipients who were treated with romosozumab for 12 mo-8 newly initiated on romosozumab and 4 treated with romosozumab after initial treatment with other agents. Endpoints were side effects, new fractures, blood tests, and changes in BMD. Pearson correlation coefficients were used to assess associations of the percent change in bone mineral density after 1 yr of treatment with age, dialysis duration, and time (yr) since transplantation. During treatment with romosozumab, the patients did not develop severe hypocalcemia or experience marked deterioration of kidney function at 1 yr post-treatment. Metabolic markers of bone formation and resorption were similar to those in the general population with osteoporosis. The average changes in BMD at the spine and total hip were 15.18% and 8.83%, respectively, indicating a favorable increase. Further, the change in spine BMD was inversely correlated with age and time since transplantation. Treatment of osteoporosis with romosozumab was observed to be safe for KTRs and had a favorable therapeutic effect on both spine and hip BMD.
肾移植受者常常会出现严重的骨质疏松症。然而，对于这些受者而言，在治疗骨质疏松症时使用何种最合适的药物尚未达成共识。在本研究中，我们调查了罗莫单抗作为肾移植受者（KTRs）严重骨质疏松症附加治疗方案的疗效。我们的回顾性观察性研究纳入了12例接受罗莫单抗治疗12个月的此类受者——8例为刚开始使用罗莫单抗，4例在最初使用其他药物治疗后改用罗莫单抗。观察指标包括副作用、新发骨折、血液检查以及骨密度变化。采用Pearson相关系数评估治疗1年后骨密度百分比变化与年龄、透析时长以及移植后时间（年）之间的关联。在使用罗莫单抗治疗期间，患者在治疗1年后未出现严重低钙血症，肾功能也未显著恶化。骨形成和骨吸收的代谢指标与一般骨质疏松症人群相似。脊柱和全髋骨密度的平均变化分别为15.18%和8.83%，表明有良好的增加。此外，脊柱骨密度变化与年龄和移植后时间呈负相关。观察发现，罗莫单抗治疗KTRs的骨质疏松症是安全的，并且对脊柱和髋部骨密度均有良好的治疗效果。
