Compliance and discontinuation of denosumab treatment in postmenopausal Japanese women with primary osteoporosis or rheumatoid arthritis and osteoporosis.
Compliance and discontinuation of denosumab treatment in postmenopausal Japanese women with primary osteoporosis or rheumatoid arthritis and osteoporosis.
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DOI：
10.1016/j.afos.2017.03.003
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发表时间：
2017-06-01
影响因子：
2
通讯作者：
Kato, Hiroyuki
中科院分区：
文献类型：
--
作者：
Suzuki, Takako;Nakamura, Yukio;Kato, Hiroyuki
目的：本研究的目的是研究日本原发性骨质疏松症或类风湿关节炎（RA）合并骨质疏松症的女性在denosumab治疗期间的停药和骨折发生情况。方法：本回顾性研究纳入143例原发性骨质疏松症患者和96例RA合并骨质疏松症患者，均采用denosumab治疗。在治疗开始前和治疗开始后1年和2年分别检测治疗停药、骨折发生率、腰椎（L1-4）骨密度（LS-BMD）和双侧全髋骨密度（TH-BMD）。结果：原发性骨质疏松组32例患者退出治疗，0 ~ 1年无骨折发生。18例失访，1 ~ 2年无骨折发生。RA合并骨质疏松组，0 ~ 1年无骨折发生，退出治疗7例。21例失访，1 ~ 2年内发生2例非椎体骨折。本组1 ~ 2年退出13例，2年研究期间因经济原因退出16例。原发性骨质疏松和RA合并骨质疏松组的LS-BMD和TH-BMD值在治疗2年期间均持续升高。结论：这些结果表明，在denosumab治疗期间，原发性骨质疏松患者的停药率有望在2年治疗期间保持较低水平。然而，在骨质疏松的RA患者中，由于经济原因，治疗1 - 2年的停药率可能会增加。
OBJECTIVES: The aim of this study was to examine the discontinuation and occurrence of fracture during denosumab treatment in Japanese women with primary osteoporosis or rheumatoid arthritis (RA) with osteoporosis.METHODS: This retrospective study included 143 patients with primary osteoporosis and 96 patients with RA and osteoporosis who were treated with denosumab. Treatment discontinuation, fracture occurrence, lumbar spine (L1-4) bone mineral density (LS-BMD), and bilateral total hip BMD (TH-BMD) were examined before and at 1 and 2 years after treatment commencement.RESULTS: In the primary osteoporosis group, 32 cases dropped out and no fractures occurred from 0 to 1 year. Eighteen cases were lost to follow-up and no fractures were noted from 1 to 2 years. In the RA with osteoporosis group, 7 cases dropped out and no fracture occurred from 0 to 1 year. Twenty-one cases were lost to follow-up and 2 nonvertebral fractures were noted from 1 to 2 years. In this group, 13 cases dropped out from 1 to 2 years and 16 cases dropped out during the 2-year study period due to economic reasons. LS-BMD and TH-BMD values increased continuously for 2 years of treatment in both primary osteoporosis and RA with osteoporosis groups.CONCLUSIONS: These results suggest that during denosumab therapy, the discontinuation rate is expected to remain low during 2 years of treatment in primary osteoporotic patients. In RA patients with osteoporosis, however, the discontinuation rate may increase due to economic reasons from 1 to 2 years of therapy.