The Effect of Zoledronic Acid on Bone Microarchitecture and Strength after Denosumab and Teriparatide Administration: DATA-HD Study Extension.
The Effect of Zoledronic Acid on Bone Microarchitecture and Strength after Denosumab and Teriparatide Administration: DATA-HD Study Extension.
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DOI：
10.1002/jbmr.4737
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发表时间：
2023-01
影响因子：
6.2
通讯作者：
Leder, Benjamin Z.
中科院分区：
文献类型：
--
作者：
Ramchand, Sabashini K.;David, Natalie L.;Lee, Hang;Bruce, Michael;Bouxsein, Mary L.;Tsai, Joy N.;Leder, Benjamin Z.
关键词：
狄诺塞麦和特立帕肽的组合是绝经后骨质疏松症的有效治疗策略，但当这些药物停用时，骨骼增益会迅速丧失。在 DATA-HD 研究中，我们报道单剂量唑来膦酸 (ZOL) 可以维持该组合所实现的区域脊柱和髋骨矿物质密度 (BMD) 的增加至少 12 个月。然而，ZOL 保持外周体积 BMD 和微结构相应改善的能力尚未见报道。在为期 15 个月的 DATA-HD 研究中，76 名绝经后骨质疏松女性被随机接受 9 个月的特立帕肽（每日 20 μg 或 40 μg）与狄诺塞麦（第 3 个月和第 9 个月 60 mg）重叠治疗。在扩展研究中，53 名参与者在最后一次服药后 24-35 周接受单剂 ZOL（5 毫克静脉注射）。我们在第 27 个月和第 42 个月时使用高分辨率外周定量计算机断层扫描测量了桡骨远端和胫骨的体积 BMD 和微结构。尽管使用了 ZOL，但总 BMD 和皮质 BMD 在 27 个月内逐渐下降，导致桡骨处的值与基线相似，但胫骨处的值仍显着高于基线。在这两个部位，皮质孔隙度在第 27 个月时均降至低于治疗前基线的值，但随后从第 27 个月增加到第 42 个月。在 ZOL 后的 27 个月观察期内，小梁参数没有显着变化。从第 15 42 个月起，两个部位的刚度和失效载荷逐渐下降，但胫骨仍高于基线。这些发现表明，与双能 X 射线骨密度测定 (DXA) 衍生的脊柱和髋部 BMD 基本保持不变相比，单剂量 ZOL 在维持狄诺塞麦和特立帕肽重叠治疗 15 个月所产生的体积外周骨密度和微结构方面的效果并不那么有效。能够完全维持周围骨参数改善的替代治疗方法需要进一步研究。 © 2022 作者。 《Journal of Bone and Mineral Research》由 Wiley periodicals LLC 代表美国骨与矿物研究学会 (ASBMR) 出版。
The combination of denosumab and teriparatide is an effective treatment strategy in postmenopausal osteoporosis, though skeletal gains are promptly lost when these agents are discontinued. In the DATA‐HD study, we reported that a single dose of zoledronic acid (ZOL) maintains the increases in areal spine and hip bone mineral density (BMD) achieved with this combination for at least 12 months. The capacity of ZOL to maintain corresponding improvements in peripheral volumetric BMD and microarchitecture, however, has not been reported. In the 15‐month DATA‐HD study, 76 postmenopausal osteoporotic women were randomized to receive 9 months of teriparatide (20‐μg or 40‐μg daily) overlapped with denosumab (60 mg at months 3 and 9). In the Extension study, 53 participants received a single dose of ZOL (5 mg intravenously) 24–35 weeks after the last denosumab dose. We measured volumetric BMD and microarchitecture at the distal radius and tibia using high‐resolution peripheral quantitative computed tomography at months 27 and 42. Despite ZOL administration, total and cortical BMD gradually decreased over 27 months resulting in values similar to baseline at the radius but still significantly above baseline at the tibia. At both sites, cortical porosity decreased to values below pretreatment baseline at month 27 but then increased from month 27 to 42. There were no significant changes in trabecular parameters throughout the 27‐month post‐ZOL observation period. Stiffness and failure load, at both sites, decreased progressively from month 15 42 though remained above baseline at the tibia. These findings suggest that in contrast to the largely maintained gains in dual‐energy X‐ray absorptiometry (DXA)‐derived spine and hip BMD, a single dose of ZOL was not as effective in maintaining the gains in volumetric peripheral bone density and microarchitecture produced by 15 months of overlapping treatment with denosumab and teriparatide. Alternative therapeutic approaches that can fully maintain improvements in peripheral bone parameters require further study. © 2022 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
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影响因子：
5.8
作者：
Leder, Benjamin Z.;Neer, Robert M.;Finkelstein, Joel S.
通讯作者：
Finkelstein, Joel S.
DOI：
10.1210/clinem/dgz095
发表时间：
2020-03-01
期刊：
The Journal of clinical endocrinology and metabolism
影响因子：
--
作者：
Kendler, David;Chines, Arkadi;Stad, Robert Kees
通讯作者：
Stad, Robert Kees
影响因子：
5.8
作者：
Boutroy, S;Bouxsein, ML;Delmas, PD
通讯作者：
Delmas, PD
影响因子：
5.8
作者：
Miller, Paul D.;Wagman, Rachel B.;McClung, Michael R.
通讯作者：
McClung, Michael R.
影响因子：
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作者：
Lindsay, R;Scheele, WH;Mitlak, BH
通讯作者：
Mitlak, BH