Valerie Konings, Michaël R Laurent, Sigrid Janssens, Jolan Dupont, Evelien Gielen, Marian Dejaeger
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引用次数: 0
Abstract
Objectives: Teriparatide (TPD) is an osteoanabolic agent used in patients with high osteoporotic fracture risk. Predictors of therapeutic response to TPD in real-life setting are not well characterised. This study investigated the influence of previous antiresorptive therapy, age and other patient characteristics on the skeletal response to TPD.
Methods: Retrospective study at the metabolic bone clinic, University Hospitals Leuven, Belgium. Patients with osteoporosis and a high fracture burden received TPD for 9-18 months. Bone mineral density (BMD) was measured at baseline, 9 and 18 months at lumbar spine (LS), femoral neck (FN) and total hip (TH).
Results: BMD at LS increased at 9 months (change mean (standard error) 6.8 % (0.7) p < 0.001) and at 18 months (8.0 % (0.9) p < 0.001), while BMD at FN and TH did not change significantly. Non-response in BMD change at the LS was seen with prior denosumab use (odds ratio 0.21, 95% confidence interval (CI) 0.049-0.912, p = 0.037). Changes in BMD at TH were significantly greater in younger patients and in patients with a lower baseline BMD.
Conclusion: TPD-induced changes in BMD at TH might depend on age and baseline BMD and at LS on prior denosumab use. The results suggest that these factors may be relevant for clinical decision making when initiating TPD treatment, although larger studies are needed to confirm these findings.
目的:特立帕肽(TPD)是一种用于骨质疏松性骨折高危患者的骨合成代谢剂。在现实生活中,TPD治疗反应的预测因素没有很好的特征。本研究调查了既往抗再吸收治疗、年龄和其他患者特征对TPD骨骼反应的影响。方法:在比利时鲁汶大学医院代谢骨诊所进行回顾性研究。骨质疏松症和高骨折负荷患者接受TPD治疗9-18 月。在基线、9和18时测量骨密度(BMD) 腰椎(LS)、股骨颈(FN)和全髋关节(TH)的月数。结果:LS的BMD在9时增加 月(变化平均值(标准误差)6.8%(0.7)p p p = 0.037)。年轻患者和基线BMD较低的患者在TH时的BMD变化明显更大。研究结果表明,在开始TPD治疗时,这些因素可能与临床决策有关,尽管还需要更大规模的研究来证实这些发现。
期刊介绍:
Acta Clinica Belgica: International Journal of Clinical and Laboratory Medicine primarily publishes papers on clinical medicine, clinical chemistry, pathology and molecular biology, provided they describe results which contribute to our understanding of clinical problems or describe new methods applicable to clinical investigation. Readership includes physicians, pathologists, pharmacists and physicians working in non-academic and academic hospitals, practicing internal medicine and its subspecialties.