Short-term daily teriparatide in patients with rheumatoid arthritis
Short-term daily teriparatide in patients with rheumatoid arthritis
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DOI：
10.1080/14397595.2017.1362093
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发表时间：
2018-01-01
影响因子：
2.2
通讯作者：
Chikuda, Hirotaka
中科院分区：
文献类型：
--
作者：
Kaneko, Tetsuya;Okamura, Koichi;Chikuda, Hirotaka
目的：本研究的目的是比较 6 个月特立帕肽治疗后 6 个月双膦酸盐治疗与 12 个月双膦酸盐单药治疗对于既往未接受过骨质疏松症治疗的日本类风湿性关节炎 (RA) 患者的疗效。 方法：共纳入 34 例患有骨质疏松症的 RA 患者。 13 名患者在 6 个月的米诺膦酸钠治疗前接受了 6 个月的特立帕肽治疗（PTH 组），21 名患者接受了 12 个月的米诺膦酸钠治疗（BP 组）。在治疗前、治疗后6个月和12个月测量骨矿物质密度(BMD)和骨转换标志物。结果：治疗12个月后，两组脊柱骨矿物质密度均显着增加。与 BP 组相比，PTH 组在开始治疗后 12 个月时脊柱 BMD 的平均百分比变化显着较高（PTH 组：9.91.5%，BP 组：5.5 +/- 0.7%）。仅在 12 个月后，PTH 组的股骨颈 BMD 显着增加。 结论：六个月特立帕肽治疗随后六个月米诺膦酸钠治疗比 12 个月米诺膦酸钠单药治疗更能增加脊柱 BMD。当考虑额外的双膦酸盐治疗时，对患有骨质疏松症的 RA 患者短期服用特立帕肽的策略可能是有用的。
Objective: The aim of this study was to compare the efficacy of six-month teriparatide treatment followed by six-month bisphosphonate therapy with 12-month bisphosphonate monotherapy in Japanese rheumatoid arthritis (RA) patients who had not been previously treated for osteoporosis.Methods: A total of 34 RA patients with osteoporosis were enrolled. Thirteen patients received six-month teriparatide prior to six-month minodronate therapy (PTH group), and 21 patients received 12-month minodronate therapy (BP group). Bone mineral density (BMD), and bone turnover markers were measured prior to and 6 and 12 months after the initiation of treatment.Results: Bone mineral density of the spine was significantly increased after 12 months of treatment in both groups. In the PTH group, the mean percent change of BMD of the spine was significantly higher at 12 months after the initiation of treatment, as compared to the BP group (PTH group: 9.91.5%, BP group: 5.5 +/- 0.7%). Femoral neck BMD was significantly increased only in the PTH group after 12 months.Conclusion: Therapy involving six-month teriparatide followed by six-month minodronate therapy increased spine BMD to a greater degree than 12-month minodronate monotherapy. The strategy of short-term administration of teriparatide for RA patients with osteoporosis might be useful when additional bisphosphonate therapy is considered.