Denosumab improves density and strength parameters as measured by QCT of the radius in postmenopausal women with low bone mineral density
Denosumab improves density and strength parameters as measured by QCT of the radius in postmenopausal women with low bone mineral density
复制标题
DOI：
10.1016/j.bone.2010.04.594
复制
发表时间：
2010-07-01
期刊：
影响因子：
4.1
通讯作者：
Libanati, C.
中科院分区：
文献类型：
--
作者：
Genant, H. K.;Engelke, K.;Libanati, C.
背景资料：骨强度由皮质骨和骨小梁间室决定，并且可以通过测量骨密度和几何形状进行放射学评估。定量计算机断层扫描（QCT）分别可靠地评估了各个部位的皮质骨和松质骨，包括桡骨远端，其中存在皮质骨和松质骨的分级。我们评估了地舒单抗（一种抑制RANK配体的全人源单克隆抗体）对低骨量女性桡骨远端QCT的影响，以评估这种新疗法分别对骨小梁和皮质骨的影响。方法：脊柱区域骨矿物质密度（BMD）T评分在-1.0和-之间的绝经后女性（n=332）2.5例在24个月研究期间每6个月接受一次地舒单抗60 mg或安慰剂。使用全身计算机断层扫描仪进行桡骨远端沿着的QCT测量，并用于确定体积BMD、体积骨矿物质含量（BMC）、皮质厚度、体积、周长和密度加权极惯性矩（PMI）（骨强度的衍生指数）相对于基线的百分比变化。Denosumab治疗显著增加了桡骨沿着（近端、远端和超远端部分）的总BMD和BMC。在24个月时，超远端区域的总BMD增加百分比最大（4.7% [95%CI，3.6-5.7]; P
Background: Bone strength is determined by both cortical and trabecular bone compartments and can be evaluated radiologically through measurement of bone density and geometry. Quantitative computed tomography (QCT) separately assesses cortical and trabecular bone reliably at various sites, including the distal radius where there is a gradation of cortical and trabecular bone. We evaluated the effect of denosumab, a fully human monoclonal antibody that inhibits RANK ligand, on distal radius QCT in women with low bone mass to assess the impact of this novel therapy separately on trabecular and cortical bone.Methods: Postmenopausal women (n=332) with spine areal bone mineral density (BMD) T-scores between -1.0 and -2.5 received denosumab 60 mg or placebo every 6 months during the 24-month study. QCT measurements along the distal radius were made using a whole-body computed tomography scanner and were used to determine the percentage change from baseline in volumetric BMD; volumetric bone mineral content (BMC); cortical thickness; volume; circumference; and density-weighted polar moment of inertia (PMI), a derived index of bone strength.Results: Denosumab treatment significantly increased total BMD and BMC along the radius (proximal, distal, and ultradistal sections). At 24 months, the ultradistal region had the greatest percentage increase in total BMD (4.7% [95% CI, 3.6-5.7]; P