Mineralization Density Distribution of Postmenopausal Osteoporotic Bone Is Restored to Normal After Long-Term Alendronate Treatment: qBEI and sSAXS Data From the Fracture Intervention Trial Long-Term Extension (FLEX)
Mineralization Density Distribution of Postmenopausal Osteoporotic Bone Is Restored to Normal After Long-Term Alendronate Treatment: qBEI and sSAXS Data From the Fracture Intervention Trial Long-Term Extension (FLEX)
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DOI：
10.1359/jbmr.090702
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发表时间：
2010-01-01
影响因子：
6.2
通讯作者：
Klaushofer, K.
中科院分区：
文献类型：
--
作者：
Roschger, P.;Lombardi, A.;Klaushofer, K.
长期治疗研究表明，阿仑膦酸钠（ALN）的治疗效果持续超过10年的治疗期。然而，关于长期骨转换减少对内在骨材料特性影响的数据仍然很少。我们分析了30名骨折干预试验长期扩展（FLEX）参与者的经髂骨活检（n = 6用ALN以10 mg/天的剂量治疗10年，n = 10用ALN以5 mg/天的剂量治疗10年，和n = 14，接受ALN治疗5年，再接受安慰剂治疗5年），通过定量背散射电子成像（qBEI）和扫描小角X射线散射（sSAXS）以确定骨矿化密度分布（BMDD）和矿物颗粒厚度参数T。将这些FLEX参与者的BMDD数据与之前发表的健康人群（n = 52）的数据进行比较。与ALN治疗5年+安慰剂治疗5年相比，ALN治疗10年（与给药剂量无关）未对任何BMDD参数产生任何差异：加权平均值（Ca-平均值）、典型钙浓度（Ca-峰值）、矿化不均匀性（钙宽度），低矿化骨面积百分比（钙低），5年后继续ALN与停止ALN的患者的高矿化区（Ca-高）比例无差异。此外，未观察到FLEX受试者与健康人群之间的任何BMDD参数存在显著差异。在所有调查病例中，均未观察到异常高矿化或矿物颗粒厚度变化（Ca-高和T均在正常范围内）。本研究的结果支持ALN抗骨吸收治疗应维持5年的建议。然而，即使治疗持续时间长达10年，也没有观察到对骨基质矿化的负面影响。(C)2010年美国骨与矿物质研究学会。
Long-term treatment studies showed that the therapeutic effects of alendronate (ALN) were sustained over a 10-year treatment period. However, data on the effects on intrinsic bone material properties by long-term reduction of bone turnover are still sparse. We analyzed transiliacal bone biopsies of a subgroup of 30 Fracture Intervention Trial Long-Term Extension (FLEX) participants (n = 6 were treated for 10 years with ALN at dose of 10 mg/day, n = 10 were treated for 10 years with ALN at dose of 5 mg/day, and n = 14 were treated for 5 years with ALN plus a further 5 years with placebo) by quantitative backscattered electron imaging (qBEI) and scanning small-angle Xray scattering (sSAXS) to determine the bone mineralization density distribution (BMDD) and the mineral particle thickness parameter T. BMDD data from these FLEX participants were compared with those from a previously published healthy population (n = 52). Compared with 5 years of ALN plus 5 years of placebo 10 years of ALN treatment (independent of the dose given) did not produce any difference in any of the BMDD parameters: The weighted mean (Ca-mean), the typical calcium concentration (Ca-peak), the heterogeneity of mineralization (Ca-width), the percentage of low-mineralized bone areas (Ca-low), and the portion of highly mineralized areas (Ca-high) were not different for the patients who continued ALN from those who stopped ALN after 5 years. Moreover, no significant differences for any of the BMDD parameters between the FLEX participants and the healthy population could be observed. In none of the investigated cases were abnormally high mineralization or changes in mineral particle thickness observed (Ca-high and T were both in the normal range). The findings of this study support the recommendation that antiresorptive treatment with ALN should be maintained for 5 years. Even with longer treatment durations of up to 10 years, though, no negative effects on bone matrix mineralization were observed. (C) 2010 American Society for Bone and Mineral Research.