Relationship between bone turnover and density with teriparatide, denosumab or both in women in the DATA study.
Relationship between bone turnover and density with teriparatide, denosumab or both in women in the DATA study.
复制标题
数据研究中女性特立帕肽、狄诺塞麦或两者的骨转换和密度之间的关系。
DOI：
10.1016/j.bone.2016.11.009
复制
发表时间：
2017
期刊：
影响因子：
4.1
通讯作者：
Leder,BZ
中科院分区：
文献类型：
--
作者：
Tsai,JN;Burnett-Bowie,SM;Lee,H;Leder,BZ
虽然骨转换生化标志物（BTM）的变化已被报道可预测骨密度（BMD）的变化，但联合抗吸收/合成代谢治疗后BMD变化与BTM之间的关系尚不清楚。（年龄51-91岁）接受特立帕鲁单抗20 mcg SC每日一次、地舒单抗60 mg SC每6个月一次或两种治疗2年。Pearson相关系数（R）进行计算，以确定基线和早期变化BTM（以及血清sclerostin）和2年的变化BMD.ResultsIn妇女接受teriparbidine，基线BTM与2年的BMD变化不相关，虽然12个月的骨钙素和P1 NP增加与2年的脊柱BMD增加。在接受地舒单抗治疗的女性中，脊柱和髋部BMD增加与基线和P1 NP和C端肽变化相关。在接受联合特立帕鲁肽/地舒单抗治疗的女性中，虽然基线和P1 NP降低均与脊柱BMD增加相关，但桡骨远端增加与CTX抑制减少相关。无论是基线还是血清sclerostin的变化与BMD在任何treatment group.Summary和conclusionsIn女性治疗teriparlavine或denosumab，早期BTM的变化（增加和减少，分别）预测2年BMD的收益，特别是在脊柱。在接受特立帕罗/地舒单抗联合治疗的女性中，桡骨远端BMD增加与骨转换抑制较少相关。这些结果表明，尽管RANKL受到抑制，但联合治疗在皮质部位（如桡骨）的疗效可能取决于残余骨重塑。
BackgroundWhile changes in biochemical markers of bone turnover (BTM) have been reported to predict changes in bone mineral density (BMD), the relationship between changes in BMD and BTMs with combined antiresorptive/anabolic therapy is unknown.MethodsIn the DATA study, 94 postmenopausal osteoporotic women (ages 51–91) received either teriparatide 20-mcg SC daily, denosumab 60-mg SC every 6 months, or both for 2 years. Pearson's correlation coefficients (R) were calculated to determine the relationship between baseline and early changes in BTMs (as well as serum sclerostin) and 2-year changes in BMD.ResultsIn women receiving teriparatide, baseline BTMs did not correlate with 2-year BMD changes though 12-month increases in osteocalcin and P1NP were associated with 2-year increases in spine BMD. In women receiving denosumab, spine and hip BMD gains correlated with both baseline and changes in P1NP and C-telopeptide. In women receiving combined teriparatide/denosumab, while both baseline and decreases in P1NP were associated with spine BMD gains, distal radius increases were associated with less CTX suppression. Neither baseline nor changes in serum sclerostin correlated with BMD in any treatment group.Summary and conclusionsIn women treated with teriparatide or denosumab, early BTM changes (increases and decreases, respectively) predict 2-year BMD gains, especially at the spine. In women treated with combined teriparatide/denosumab therapy, BMD increases at the distal radius were associated with less suppression of bone turnover. These results suggest that efficacy of combination therapy at cortical sites such as the radius may depend on residual bone remodeling despite RANKL inhibition.