Intravenous bisphosphonate therapy increases radial width in adults with osteogenesis imperfecta
Intravenous bisphosphonate therapy increases radial width in adults with osteogenesis imperfecta
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DOI：
10.1359/jbmr.050312
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发表时间：
2005-08-01
影响因子：
6.2
通讯作者：
Adami, S
中科院分区：
文献类型：
--
作者：
Gatti, D;Viapiana, O;Adami, S
前言：双膦酸类药物可使成骨不全(OI)患者的骨折风险降低70-90%。这一下降比从骨密度变化中预期的要大一些，这支持了双膦酸盐治疗与结构变化相关的假设，而骨密度测量无法检测到这一假设。材料和方法：为了探索这一假说，在一组成年OI患者中，参与了一项随机临床试验，测量了非优势桡骨的pQCT测量。结果：与钙+维生素D单独治疗组(对照组)相比，接受奈立磷酸和钙+维生素D治疗的患者超远端桡骨的总体积骨密度显著增加。骨小梁密度和体积皮质密度在两组间均无显著差异。在尼立磷酸组，横截面积较基线值和对照组均显著增加。后一种变化与弯曲断裂抵抗指数(BBRI)增加20%类似。结论：如果我们的观察延伸到绝经后骨质疏松症，可能会为双膦酸类药物治疗骨质疏松症患者骨折风险的降低提供新的解释。
Introduction: Bisphosphonate therapy decreases by 70-90% the fracture risk in patients with osteogenesis imperfecta (OI). This decrease is somewhat greater than that expected from the BMD changes, supporting the hypothesis that bisphosphonate therapy is associated with structural changes, not detectable by BMD measurements.Materials and Methods: To explore this hypothesis, pQCT measurements at the nondominant radius were obtained in a group of adult OI patients participating in a randomized clinical trial with neridronate.Results: The total volumetric BMD of the ultradistal radius rose significantly in patients treated with neridronate and calcium + vitamin D (neridronate group) compared with patients treated with calcium + vitamin D alone (control group). No significant differences were observed in trabecular BMD and in volumetric cortical density in either group. In the neridronate group, the cross-sectional area rose significantly versus both baseline values and the control group. These latter changes were associated with similar to 20% increases in bending breaking resistance index (BBRI).Conclusion: Our observation, if extended to postmenopausal osteoporosis, may provide a new explanation for the fracture risk reduction observed in osteoporotic patients treated with bisphosphonates.