阿法骨化醇在临床实践中的应用:关注俄罗斯仿制药的疗效和安全性

N. Toroptsova, M. Kozyreva, O. Dobrovolskaya
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摘要

决定骨折风险的最重要因素不仅是是否患有骨质疏松症(OP),还有跌倒的风险。除了充足的体育锻炼外,还需要服用对骨骼肌的力量和功能表现有积极影响的药物。目的:研究非专利药物阿法骨化醇 Canon 在临床实践中对骨矿物质密度降低患者功能状态的耐受性、安全性和有效性。研究涉及 30 名患有 OP 或骨质疏松症的高危女性(平均年龄为 68.0±7.2 岁),她们接受了为期 3 个月的阿法骨化醇卡农治疗,剂量为 1 微克/天。随访期包括 4 次门诊,期间进行了实验室检查,并对跌倒和骨折、不良反应以及患者的治疗依从性进行了登记。在第一次和最后一次就诊时,使用 EQ-5D 评估了生活质量,并检查了骨骼肌的功能状态。在第四次就诊时,对药物的耐受性进行了评估。治疗 3 个月后,优势臂的肌肉力量平均增加了 15.4%(P=0.00002)。椅子站立测试 "和 "起立计时 "测试的时间分别缩短了 17.4% (p=0.000012) 和 13.6% (p=0.00004)。步速测试平均提高了 13.9%(p=0.000013),26 名(86.7%)女性的步速有所提高。SPPB测试得分平均提高了12.5%(p=0.000001),23名(76.7%)女性达到了最佳指标。没有出现高钙血症、高磷血症和高镁血症,但发现了 1 例高钙尿症。有 2 名妇女(6.7%)曾在上一年跌倒,其中一人肱骨颈骨折。3名妇女(10%)出现了不良反应,其中一人停止了服药。90% 的患者对治疗的耐受性良好。平均依从率为 94.3%。阿法骨化醇 Canon 是一种安全有效的药物,可用于改善高跌倒风险患者骨骼肌的体能表现。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Alfacalcidol in clinical practice: focus on the efficacy and safety of the Russian generic drug
The most important factors that determine the risk of fractures are not only the presence of osteoporosis (OP), but also the risk of falls. In addition to sufficient physical activity, medications are needed that have a positive effect on the strength and functional performance of the skeletal muscles. Vitamin D supplements play a key role in this therapeutic approach.Objective: to investigate the tolerability, safety and efficacy of the generic drug Alfacalcidol Canon on the functional status of patients with reduced bone mineral density in clinical practice.Material and methods. The study involved 30 women with OP or osteopenia who were at high risk of falls (mean age 68.0±7.2 years) and who were administered Alfacalcidol Canon at a dose of 1 mcg/day for 3 months. The follow-up period included 4 visits to the clinic, during which laboratory tests were performed and falls and fractures, adverse reactions and patients' adherence to treatment were registered. At the first and last visits, quality of life was assessed using the EQ-5D and the functional status of the skeletal muscles was examined. At the 4th visit, the tolerability of the medication was assessed.Results and discussion. After 3 months of therapy, an increase in muscle strength of the dominant arm was observed by an average of 15.4% (p=0.00002). The time for the "Chair Stand Test" and the "Time up and go" test decreased by 17.4% (p=0.000012) and 13.6% (p=0.00004) respectively. The gait speed test increased on average by 13.9% (p=0.000013), it increased in 26 (86.7%) women. The SPPB test score increased on average by 12.5% (p=0.000001), and achievement of the best indicators was found in 23 (76.7%) women. There were no cases of hypercalcemia, hyperphosphatemia and hypermagnesemia, but 1 case of hypercalciuria was detected. Falls occurred in 2 women (6.7%) who had fallen in the previous year, one of whom suffered a fracture of humeral neck. Adverse reactions were observed in 3 (10 %) women, one of whom stopped taking the drug. 90% of the patients tolerated the treatment excellently. The average compliance rate was 94.3%.Conclusion. Alfacalcidol Canon is a safe and effective drug that can be used to improve the physical performance of skeletal muscles in patients with a high risk of falls.
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