Daily and cyclic parathyroid hormone in women receiving alendronate
Daily and cyclic parathyroid hormone in women receiving alendronate
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DOI：
10.1056/nejmoa050157
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发表时间：
2005-08-11
影响因子：
158.5
通讯作者：
Lindsay, R
中科院分区：
文献类型：
--
作者：
Cosman, F;Nieves, J;Lindsay, R
背景：我们评估了长期接受阿仑膦酸钠治疗的骨质疏松症患者是否对甲状旁腺激素治疗有反应，以及为期三个月的短周期甲状旁腺激素治疗是否与每日给药一样有效。 方法：我们将 126 名已服用阿仑膦酸钠至少 1 年的骨质疏松症女性随机分配至继续每天皮下注射阿仑膦酸钠加甲状旁腺激素 (1-34) 组、继续皮下注射阿仑膦酸钠加甲状旁腺激素 (1-34) 组每日一次，为期 3 个 3 个月的周期，与 3 个月不使用甲状旁腺激素的周期交替进行，或单独使用阿仑膦酸钠 15 个月。 结果：在两个甲状旁腺激素组中，骨形成指数均迅速上升。在接受周期性甲状旁腺激素的女性中，骨形成在没有甲状旁腺激素的周期中下降，而在使用甲状旁腺激素的周期中再次增加。两个甲状旁腺激素组的骨吸收均有所增加，但每日治疗组的骨吸收增加程度高于循环治疗组。每日治疗组的脊柱骨密度增加了 6.1%，循环治疗组增加了 5.4%（P
BACKGROUND:We evaluated whether patients with osteoporosis treated with long-term alendronate have a response to parathyroid hormone treatment and whether short, three-month cycles of parathyroid hormone therapy could be as effective as daily administration.METHODS:We randomly assigned 126 women with osteoporosis who had been taking alendronate for at least 1 year to continued alendronate plus parathyroid hormone (1-34) subcutaneously daily, continued alendronate plus parathyroid hormone (1-34) subcutaneously daily for three 3-month cycles alternating with 3-month periods without parathyroid hormone, or alendronate alone for 15 months.RESULTS:In both parathyroid hormone groups, bone formation indexes rose swiftly. Among the women who were receiving cyclic parathyroid hormone, bone formation declined during cycles without parathyroid hormone and increased again during cycles with parathyroid hormone. Bone resorption increased in both parathyroid hormone groups but increased progressively more in the daily-treatment group than in the cyclic-therapy group. Spinal bone mineral density rose 6.1 percent in the daily-treatment group and 5.4 percent in the cyclic-therapy group (P