{"title":"既往抗骨质疏松治疗对地诺单抗在华东绝经后骨质疏松妇女骨密度变化中的顺序反应的影响：真实世界数据分析","authors":"Guoyu Guan, Yanping Du, Wenjing Tang, Minmin Chen, Weijia Yu, Huilin Li, Qun Cheng","doi":"10.2147/CIA.S511622","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate the impacts of prior anti-osteoporosis treatments on bone mineral density (BMD) changes in Chinese postmenopausal women with osteoporosis following 1-year Denosumab (Dmab) therapy.</p><p><strong>Patients and methods: </strong>This retrospective cohort study enrolled 381 postmenopausal women, all receiving a 1-year Dmab treatment. Participants were stratified into five groups based on prior anti-osteoporosis treatments: no treatment (NT), alendronate (ALN), zoledronic acid (ZOL), teriparatide (TPT), and raloxifene (RAL). Potential factors influencing BMD changes were screened using least absolute shrinkage and selection operator (LASSO). The selected variables were then incorporated into a multivariate regression model to identify independent risk factors. Finally, after adjusting for confounders, the impacts of prior anti-osteoporosis treatment on sequential Dmab responses were evaluated.</p><p><strong>Results: </strong>1) Further BMD increases were observed after sequential 1-year Dmab with prior use of other anti-osteoporosis drugs; 2) Compared to the NT group, ZOL significantly reduced BMD changes at the lumbar spine (LS), femoral neck (FN), and total hip (TH) (LS: β = -0.01, P = 0.016; FN: β = -0.01, <i>P</i> = 0.010; TH: β = -0.01, <i>P</i> = 0.011); Significant negative associations with FN BMD changes were observed for the ALN group (β = -0.01, <i>P</i>< 0.001), and the RAL group (β = -0.01, <i>P</i> = 0.010) compared to the NT group; TPT showed no significant differences with the NT group at all sites; 3) Multiple analysis revealed baseline BMD were independently associated with changes in BMD (LS: β = -0.04, <i>P</i> = 0.009; FN: β = -0.19, <i>P</i> <0.001; TH: β = -0.14, <i>P</i> <0.001).</p><p><strong>Conclusion: </strong>These findings indicated that prior anti-osteoporosis treatments differentially influenced BMD responses to 1-year Dmab therapy. While patients who had previously been treated with ZOL had limited subsequent BMD improvement, patients who had previously used TPT and had lower baseline BMD benefited more.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"573-586"},"PeriodicalIF":3.5000,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068388/pdf/","citationCount":"0","resultStr":"{\"title\":\"Impacts of Prior Anti-Osteoporosis Treatments on Sequential Denosumab Responses in BMD Changes Among Postmenopausal Osteoporosis Women in East China: Real-World Data Analysis.\",\"authors\":\"Guoyu Guan, Yanping Du, Wenjing Tang, Minmin Chen, Weijia Yu, Huilin Li, Qun Cheng\",\"doi\":\"10.2147/CIA.S511622\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>This study aimed to investigate the impacts of prior anti-osteoporosis treatments on bone mineral density (BMD) changes in Chinese postmenopausal women with osteoporosis following 1-year Denosumab (Dmab) therapy.</p><p><strong>Patients and methods: </strong>This retrospective cohort study enrolled 381 postmenopausal women, all receiving a 1-year Dmab treatment. Participants were stratified into five groups based on prior anti-osteoporosis treatments: no treatment (NT), alendronate (ALN), zoledronic acid (ZOL), teriparatide (TPT), and raloxifene (RAL). Potential factors influencing BMD changes were screened using least absolute shrinkage and selection operator (LASSO). The selected variables were then incorporated into a multivariate regression model to identify independent risk factors. Finally, after adjusting for confounders, the impacts of prior anti-osteoporosis treatment on sequential Dmab responses were evaluated.</p><p><strong>Results: </strong>1) Further BMD increases were observed after sequential 1-year Dmab with prior use of other anti-osteoporosis drugs; 2) Compared to the NT group, ZOL significantly reduced BMD changes at the lumbar spine (LS), femoral neck (FN), and total hip (TH) (LS: β = -0.01, P = 0.016; FN: β = -0.01, <i>P</i> = 0.010; TH: β = -0.01, <i>P</i> = 0.011); Significant negative associations with FN BMD changes were observed for the ALN group (β = -0.01, <i>P</i>< 0.001), and the RAL group (β = -0.01, <i>P</i> = 0.010) compared to the NT group; TPT showed no significant differences with the NT group at all sites; 3) Multiple analysis revealed baseline BMD were independently associated with changes in BMD (LS: β = -0.04, <i>P</i> = 0.009; FN: β = -0.19, <i>P</i> <0.001; TH: β = -0.14, <i>P</i> <0.001).</p><p><strong>Conclusion: </strong>These findings indicated that prior anti-osteoporosis treatments differentially influenced BMD responses to 1-year Dmab therapy. While patients who had previously been treated with ZOL had limited subsequent BMD improvement, patients who had previously used TPT and had lower baseline BMD benefited more.</p>\",\"PeriodicalId\":48841,\"journal\":{\"name\":\"Clinical Interventions in Aging\",\"volume\":\"20 \",\"pages\":\"573-586\"},\"PeriodicalIF\":3.5000,\"publicationDate\":\"2025-05-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068388/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Interventions in Aging\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2147/CIA.S511622\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"GERIATRICS & GERONTOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Interventions in Aging","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/CIA.S511622","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的：本研究旨在探讨既往抗骨质疏松治疗对中国绝经后骨质疏松妇女接受Denosumab （Dmab）治疗1年后骨密度（BMD）变化的影响。患者和方法：本回顾性队列研究纳入381名绝经后妇女，均接受1年Dmab治疗。参与者根据先前的抗骨质疏松治疗分为五组：无治疗（NT）、阿仑膦酸（ALN）、唑来膦酸（ZOL）、特立帕肽（TPT）和雷洛昔芬（RAL）。采用最小绝对收缩和选择算子（LASSO）筛选影响骨密度变化的潜在因素。然后将选定的变量纳入多元回归模型以确定独立的危险因素。最后，在调整混杂因素后，评估先前抗骨质疏松治疗对顺序Dmab反应的影响。结果：1)连续使用Dmab 1年后，既往使用其他抗骨质疏松药物后，骨密度进一步升高；2)与NT组相比，ZOL显著降低了腰椎（LS）、股骨颈（FN）和全髋关节（TH）的BMD变化(LS: β = -0.01, P = 0.016；Fn: β = -0.01, p = 0.010；Th: β = -0.01, p = 0.011)；与NT组相比，ALN组（β = -0.01， P< 0.001）和RAL组（β = -0.01, P = 0.010）与FN骨密度变化呈显著负相关；TPT组与NT组在各部位均无显著差异；3)多项分析显示基线骨密度与骨密度变化独立相关(LS: β = -0.04, P = 0.009；FN: β = -0.19， P P结论：这些发现表明先前的抗骨质疏松治疗对1年Dmab治疗的BMD反应有差异。虽然先前接受ZOL治疗的患者随后的骨密度改善有限，但先前使用TPT且基线骨密度较低的患者受益更多。
Impacts of Prior Anti-Osteoporosis Treatments on Sequential Denosumab Responses in BMD Changes Among Postmenopausal Osteoporosis Women in East China: Real-World Data Analysis.
Purpose: This study aimed to investigate the impacts of prior anti-osteoporosis treatments on bone mineral density (BMD) changes in Chinese postmenopausal women with osteoporosis following 1-year Denosumab (Dmab) therapy.
Patients and methods: This retrospective cohort study enrolled 381 postmenopausal women, all receiving a 1-year Dmab treatment. Participants were stratified into five groups based on prior anti-osteoporosis treatments: no treatment (NT), alendronate (ALN), zoledronic acid (ZOL), teriparatide (TPT), and raloxifene (RAL). Potential factors influencing BMD changes were screened using least absolute shrinkage and selection operator (LASSO). The selected variables were then incorporated into a multivariate regression model to identify independent risk factors. Finally, after adjusting for confounders, the impacts of prior anti-osteoporosis treatment on sequential Dmab responses were evaluated.
Results: 1) Further BMD increases were observed after sequential 1-year Dmab with prior use of other anti-osteoporosis drugs; 2) Compared to the NT group, ZOL significantly reduced BMD changes at the lumbar spine (LS), femoral neck (FN), and total hip (TH) (LS: β = -0.01, P = 0.016; FN: β = -0.01, P = 0.010; TH: β = -0.01, P = 0.011); Significant negative associations with FN BMD changes were observed for the ALN group (β = -0.01, P< 0.001), and the RAL group (β = -0.01, P = 0.010) compared to the NT group; TPT showed no significant differences with the NT group at all sites; 3) Multiple analysis revealed baseline BMD were independently associated with changes in BMD (LS: β = -0.04, P = 0.009; FN: β = -0.19, P <0.001; TH: β = -0.14, P <0.001).
Conclusion: These findings indicated that prior anti-osteoporosis treatments differentially influenced BMD responses to 1-year Dmab therapy. While patients who had previously been treated with ZOL had limited subsequent BMD improvement, patients who had previously used TPT and had lower baseline BMD benefited more.
期刊介绍：
Clinical Interventions in Aging, is an online, peer reviewed, open access journal focusing on concise rapid reporting of original research and reviews in aging. Special attention will be given to papers reporting on actual or potential clinical applications leading to improved prevention or treatment of disease or a greater understanding of pathological processes that result from maladaptive changes in the body associated with aging. This journal is directed at a wide array of scientists, engineers, pharmacists, pharmacologists and clinical specialists wishing to maintain an up to date knowledge of this exciting and emerging field.
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