Effects of prior osteoporosis treatment on the treatment response of romosozumab followed by denosumab in patients with postmenopausal osteoporosis
Effects of prior osteoporosis treatment on the treatment response of romosozumab followed by denosumab in patients with postmenopausal osteoporosis
复制标题
绝经后骨质疏松患者既往骨质疏松治疗对罗莫索单抗和地诺单抗治疗反应的影响
DOI：
10.1007/s00198-022-06386-y
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发表时间：
2022-04-01
影响因子：
4
通讯作者：
Nakata, K.
中科院分区：
文献类型：
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作者：
Ebina, K.;Etani, Y.;Nakata, K.
在绝经后骨质疏松症患者中，先前的骨质疏松治疗影响了罗莫佐单抗治疗12个月后骨密度的增加，但不影响罗莫佐单抗治疗后12个月的骨密度增加。目的探讨绝经后骨质疏松症患者既往骨质疏松治疗对罗莫佐单抗(ROMO)和地诺舒单抗(DMAb)疗效的影响。方法在这项前瞻性、观察性、多中心的研究中，55例未接受治疗的患者(n=55)或曾接受双膦酸类药物(BP；n=37)、二甲基单抗(DMAb；n=45)或特瑞帕特(TPTD；n=17)治疗的患者(平均年龄74.6岁；腰椎[LS]-3.2和全髋关节[TH]-2.6)转为ROMO治疗12个月，随后使用DMAb治疗12个月。术后24个月测定骨密度(BMD)和血清骨转换指标。结果在12个月和24个月时，以下患者的骨密度增加：单纯(18.2%和22.0%)，血压(10.2%和12.1%)，DMAb(6.6%和9.7%)，TPTD(10.8%和15.0%)(P<；0.001 12个月和24个月时LS和NAIVE(5.5%和8.3%)，BP(2.9%和4.1%)，DMAb(0.6%和2.2%)，TPTD(4.3%和5.4%)(P<；0.01，24个月P<；0.001)。LS患者12~24个月骨密度增加与24个月骨吸收标记物水平呈负相关。各组的主要脆性骨折发生率分别为：NAIVE(5.5%)、BP(16.2%)、DMAb(11.1%)和TPTD(5.9%)。结论既往治疗对ROMO治疗后骨密度的增加有影响，但不影响ROMO后DMAb治疗后骨密度的增加。
In patients with postmenopausal osteoporosis, prior osteoporosis treatment affected the bone mineral density increase of following treatment with 12 months of romosozumab, although it did not affect that of following treatment with 12 months of denosumab after romosozumab. Purpose To investigate the effects of prior osteoporosis treatment on the response to treatment with romosozumab (ROMO) followed by denosumab (DMAb) in patients with postmenopausal osteoporosis. Methods In this prospective, observational, multicenter study, treatment-naive patients (Naive; n = 55) or patients previously treated with bisphosphonates (BP; n = 37), DMAb (DMAb; n = 45) or teriparatide (TPTD; n = 17) (mean age, 74.6 years; T-scores of the lumbar spine [LS] - 3.2 and total hip [TH] - 2.6) were switched to ROMO for 12 months, followed by DMAb for 12 months. Bone mineral density (BMD) and serum bone turnover markers were evaluated for 24 months. Results A BMD increase was observed at 12 and 24 months in the following patients: Naive (18.2% and 22.0%), BP (10.2% and 12.1%), DMAb (6.6% and 9.7%), and TPTD (10.8% and 15.0%) (P < 0.001 between the groups at both 12 and 24 months) in LS and Naive (5.5% and 8.3%), BP (2.9% and 4.1%), DMAb (0.6% and 2.2%), and TPTD (4.3% and 5.4%) (P < 0.01 between the groups at 12 months and P < 0.001 at 24 months) in TH, respectively. The BMD increase in LS from 12 to 24 months was negatively associated with the levels of bone resorption marker at 24 months. Incidences of major fragility fractures for the respective groups were as follows: Naive (5.5%), BP (16.2%), DMAb (11.1%), and TPTD (5.9%). Conclusions Previous treatment affected the BMD increase of following treatment with ROMO, although it did not affect that of following treatment with DMAb after ROMO.