Early responsiveness of women with osteoporosis to teriparatide after therapy with alendronate or risedronate
Early responsiveness of women with osteoporosis to teriparatide after therapy with alendronate or risedronate
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DOI：
10.1210/jc.2008-0353
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发表时间：
2008-10-01
影响因子：
5.8
通讯作者：
Bilezikian, John P.
中科院分区：
文献类型：
--
作者：
Miller, Paul D.;Delmas, Pierre D.;Bilezikian, John P.
背景：在既往接受过阿仑膦酸钠治疗的患者中，对特立哌酮的合成代谢反应可能减弱或延迟。这种影响的程度与其他抗吸收药不同。本研究评估了早期合成代谢的影响，在绝经后妇女与骨质疏松症先前治疗阿仑膦酸钠或利塞膦酸钠。方法：患者治疗至少24个月，阿仑膦酸钠或利塞膦酸钠停止他们的双膦酸盐，并收到特立帕明为12个月。主要终点是比较既往双膦酸盐治疗组之间3个月后1型胶原N-末端前肽较基线的变化。我们还检查了其他骨转换标志物、骨矿物质密度（BMD）的变化，以及骨转换标志物早期变化与12个月面积和体积BMD之间的关系。在利塞膦酸钠组中，特立帕肽治疗3个月后，1型胶原N-末端前肽的增加显著大于阿仑膦酸钠组（平均值+/-SE，分别为86.0 +/-5.6 vs 61.2 +/-5.3 ng/ml; P < 0.001）。其他骨转换标志物的结果相似。利塞膦酸钠治疗组骨密度和骨小梁体积骨密度的变化也明显大于对照组（P < 0.05）。骨转换标志物的早期变化与12个月时骨小梁体积BMD的变化相关（斯皮尔曼r = 0.45）。Teriparbal was well tolerable.Conclusion：这项非随机但前瞻性的研究表明，作为先前双膦酸盐暴露类型的函数，对teriparbal的合成代谢反应可能存在差异。
Background: Anabolic responsiveness to teriparatide can be blunted or delayed in patients previously treated with alendronate. The extent of this effect is different for other antiresorptives. This study evaluated the early anabolic effects of teriparatide in postmenopausal women with osteoporosis previously treated with alendronate or risedronate.Methods: Patients treated for at least 24 months with alendronate or risedronate discontinued their bisphosphonate and received teriparatide for 12 months. The primary endpoint was a comparison of changes from baseline in N-terminal propeptide of type 1 collagen after 3 months between prior bisphosphonate groups. We also examined changes in other bone turnover markers, bone mineral density (BMD), and relationships between early changes in bone turnover markers and 12-month areal and volumetric BMD.Results: In the prior risedronate group, the N-terminal propeptide of type 1 collagen increase was significantly greater after 3 months of teriparatide than in the prior alendronate group (mean +/-SE, 86.0 +/-5.6 vs. 61.2 +/- 5.3 ng/ml, respectively; P < 0.001). Findings were similar for the other bone turnover markers. The changes in areal BMD and trabecular spine volumetric BMD were also greater in the prior risedronate group (P < 0.05). Early changes in bone turnover markers correlated with changes in trabecular spine volumetric BMD at 12 months (Spearman r = 0.45). Teriparatide was well tolerated.Conclusion: This nonrandomized but prospective study suggests that there may be differences in anabolic responsiveness to teriparatide as a function of the type of prior bisphosphonate exposure.