Storm T, Steiniche T, Thamsborg G, Melsen F
Department of Medicine, Sundby Hospital, Copenhagen, Denmark.
J Bone Miner Res. 1993 Feb;8(2):199-208. doi: 10.1002/jbmr.5650080211.
Intermittent, cyclic etidronate therapy (400 mg/day for 2 weeks followed by 13 weeks free from study drug administration) resulted in a significant increase in lumbar bone mineral content and a significant decrease in the rate of new vertebral fractures in patients with postmenopausal osteoporosis. To investigate the effect of the treatment on bone histomorphometry, transiliac crest bone biopsy samples were obtained in this study before treatment and after 60 and 150 weeks of treatment with either intermittent, cyclic etidronate (n = 33) or placebo (n = 33). After 60 weeks of etidronate therapy, significant decreases in activation frequency (from 0.55 to 0.09 year,-1 P < 0.01) and resorption depth (from 53.2 to 37.8 microns, P < 0.05) were observed, leading to a positive balance per remodeling cycle. In the placebo group, no significant changes were seen. The 150 week bone biopsy samples were suboptimal for analysis, probably as a result of a regional acceleratory phenomenon. Our results suggest that, as a result of reductions in both activation frequency and resorption depth, intermittent, cyclic etidronate therapy may protect the trabecular network against fortuitous perforations and thereby maintain the strength of the bony tissue.
间歇性、周期性依替膦酸疗法（每日400毫克，持续2周，随后13周不服用研究药物）使绝经后骨质疏松症患者的腰椎骨矿物质含量显著增加，新椎体骨折发生率显著降低。为了研究该治疗对骨组织形态计量学的影响，本研究在治疗前以及接受间歇性、周期性依替膦酸（n = 33）或安慰剂（n = 33）治疗60周和150周后获取了髂嵴骨活检样本。依替膦酸治疗60周后，观察到激活频率显著降低（从0.55降至0.09年-1，P < 0.01）和吸收深度显著降低（从53.2微米降至37.8微米，P < 0.05），导致每个重塑周期出现正平衡。在安慰剂组中，未观察到显著变化。150周的骨活检样本不太适合进行分析，可能是由于局部加速现象所致。我们的结果表明，由于激活频率和吸收深度均降低，间歇性、周期性依替膦酸疗法可能保护小梁网络免受偶然穿孔的影响，从而维持骨组织的强度。
