Predictive value of bone resorption and formation markers in cancer patients with bone metastases receiving the bisphosphonate zoledronic acid
Predictive value of bone resorption and formation markers in cancer patients with bone metastases receiving the bisphosphonate zoledronic acid
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DOI：
10.1200/jco.2005.06.091
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发表时间：
2005-08-01
影响因子：
45.3
通讯作者：
Cook, R
中科院分区：
文献类型：
--
作者：
Coleman, RE;Major, P;Cook, R
目的：最近三项针对骨转移患者的大型随机试验证实唑来膦酸可降低骨转移相关事件的风险。这些试验提供了一个机会，调查骨代谢和临床结果之间的相关性，在bisphosphonatetherapy.Patients和MethodsUrinary测量N-端肽（Ntx）和血清骨碱性磷酸酶（BAP），获得了1,824双膦酸盐治疗的患者-1,462与唑来膦酸（乳腺癌，490;前列腺，411;骨髓瘤，210;非小细胞肺，183;其他，168）和362与帕米膦酸盐（乳腺癌，254;骨髓瘤，108）。这项探索性队列分析将患者按基线和最近Ntx水平分为低（< 50 nmol/mmol肌酐）、中等（50至99 nmol/mmol肌酐）或高（>= 100 nmol/mmol肌酐），BAP分为低（< 146 U/U或高（？146 U/U。使用多事件和考克斯回归模型估计各组阴性临床结局的相对风险，并采用随时间变化的协变量。
PurposeThree large, randomized trials of patients with bone metastases recently demonstrated that zoledronic acid reduces the risk of skeletal-related events. These trials provide an opportunity for investigating the correlation between bone metabolism and clinical outcome during bisphosphonate therapy.Patients and MethodsUrinary measurements of N-telopeptide (Ntx) and serum bone alkaline phosphatase (BAP) were obtained in 1,824 bisphosphonate-treated patients-1,462 with zoledronic acid (breast, 490; prostate, 411; myeloma, 210; non-small-cell lung, 183; other, 168) and 362 with pamidronate (breast, 254; myeloma, 108). This exploratory cohort analysis grouped patients by baseline and most recent levels of Ntx as low (< 50 nmol/mmol creatinine), moderate (50 to 99 nmol/mmol creatinine), or high (>= 100 nmol/mmol creatinine), and BAP as low (< 146 U/U or high (? 146 U/U. The relative risks for negative clinical outcomes were estimated for each group using multiple-event and Cox regression models with time-varying covariates.ResultsPatients with high and moderate Ntx levels had 2-fold increases in their risk of skeletal complications and disease progression compared with patients with low Ntx levels (P