特立帕肽序贯地舒单抗或唑来膦酸治疗OVCF患者的疗效比较
Comparison of the efficacy of teriparatide sequential denosumab and sequential zoledronic acid in the treatment of OVCF patients
杨崇正 1刘衡 1吴志浩 1黄凯华 1王贯通 1吴佳璇 1孙强1
作者信息
- 1. 南京医科大学附属南京医院,江苏 南京 210006
- 折叠
摘要
目的 观察骨质疏松性椎体压缩性骨折(osteoporotic vertebral compression fracture,OVCF)患者在经皮椎体成形术后使用特立帕肽序贯地舒单抗对比序贯唑来膦酸治疗绝经后骨质疏松症的疗效.方法 回顾性选择 2020 年 12 月至 2023 年 12月在南京市第一医院行经皮椎体成形术且术后使用特立帕肽治疗 12 个月的绝经后骨质疏松症患者 60 例,根据序贯用药情况将纳入患者分为特立帕肽序贯地舒单抗组和特立帕肽序贯唑来膦酸组,每组 30 例.比较两组治疗前、治疗 6 个月、治疗 12 个月的血清P1NP、血清β-CTX、腰椎及髋部骨密度(bone mineral density,BMD)变化情况和再骨折的发生情况,评估两组的疗效差异.结果 地舒单抗组治疗 12 个月的髋部BMD增长率高于唑来膦酸组(P=0.001).两组治疗 12 个月后的腰椎和髋部BMD均高于治疗前(P＜0.05),地舒单抗组和唑来膦酸组治疗 12 个月的腰椎BMD较治疗前分别提升 8.7%和 6.7%,髋部BMD较治疗前分别提升 6.6%和 2.9%.地舒单抗组治疗 6 个月、12 个月的血清P1NP和血清β-CTX水平均低于唑来膦酸组(P＜0.05).两组治疗期间再骨折发生率无统计学差异(P＞0.05).结论 合并OVCF的绝经后骨质疏松症患者,特立帕肽序贯地舒单抗较序贯唑来膦酸对提高髋部骨密度和降低骨代谢标志物的作用更明显,两种治疗方案对再骨折的发生率无明显影响.
Abstract
Objective To investigate the difference in the efficacy of sequent teriparatide with denosumab and sequent teriparatide with zoledronic acid in the treatment of osteoporosis in patients with osteoporotic vertebral compression fracture after percutaneous vertebroplasty.Methods A retrospective selection was conducted on 60 postmenopausal osteoporosis patients who underwent percutaneous vertebroplasty at the Nanjing First Hospital from December 2020 to December 2023 and were treated with terlipide for 12 months postoperatively.According to the sequential medication situation,the patients were divided into the denosumab group and the zoledronic acid group,with 30 cases in each group.The changes of serum P1NP,serum β-CTX,lumbar spine BMD,hip BMD and the occurrence of refracture were compared between the two groups before treatment,at 6th month and at 12th month,and the differences of curative effect between the two groups were evaluated.Results The BMD growth rate of hip in the denosumab group was higher than that in the zoledronic acid group after12 months of treatment(P＜0.05).The BMD of lumbar spine and hip in the two groups at 12th month was higher than that before treatment(P＜0.05).The BMD of lumbar spine in the denosumab group and the zoledronic acid group at 12th month was 8.7%and 6.7%higher than that before treatment,respectively.The BMD of hip in the denosumab group and the zoledronic acid group at 12th month was 6.6%and 2.9%higher than that before treatment,respectively.The levels of serum P1NP and serum β-CTX in the denosumab group were lower than those in the zoledronic acid group at 6th month and at 12th month(P＜0.05).There was no significant difference in the incidence of refracture between the two groups during treatment(P＞0.05).Conclusion In postmenopausal osteoporosis patients with OVCF,teriparatide sequent with denosumab is more effective than sequent with zoledronic acid in increasing bone mineral density in the hip and reducing bone metabolism markers.The two treatment regimens have no significant effect on the incidence of recurrent fractures.
关键词
绝经后骨质疏松症/特立帕肽/唑来膦酸/地舒单抗/序贯治疗Key words
postmenopausal osteoporosis/teriparatide/zoledronic acid/denosumab/sequential therapy引用本文复制引用
基金项目
江苏省老年健康科研项目(LK2021031)
出版年
2024
NETL
NSTL
万方数据