Relationships between biochemical markers of bone and cartilage degradation with radiological progression in patients with knee osteoarthritis receiving risedronate: the Knee Osteoarthritis Structural Arthritis randomized clinical trial
Relationships between biochemical markers of bone and cartilage degradation with radiological progression in patients with knee osteoarthritis receiving risedronate: the Knee Osteoarthritis Structural Arthritis randomized clinical trial
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DOI：
10.1016/j.joca.2007.10.002
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发表时间：
2008-06-01
影响因子：
7
通讯作者：
Bingham, C. O., III
中科院分区：
文献类型：
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作者：
Garnero, P.;Aronstein, W. S.;Bingham, C. O., III
目的：研究骨和软骨生化标志物（NTX-1）的早期变化是否（CTX-II [II型胶原的C-末端交联端肽]）降解与接受利塞膦酸盐的膝骨关节炎（OA）患者的放射学进展相关。设计：在北美（NA）的两项为期24个月的研究中，2483例膝关节内侧间室OA患者被随机分组和欧洲联盟（欧盟）。研究评价了利塞膦酸钠5 mg/天、35 mg/周（EU）、50 mg/周（NA）和15 mg/天（NA和EU）与安慰剂相比在减轻体征和症状以及减缓放射学进展方面的作用。1885例患者从欧盟和NA的研究与可用的NTX-I/CTX-II在基线和6个月，并在基线和24 months的X光片进行了analyzed.Results：利塞膦酸钠产生了剂量依赖性减少NTX-I和CTX-II观察在6个月，持续到24个月。与基线和6个月时CTX-II水平均升高的患者相比，6个月时CTX-II水平恢复至低水平（肌酐< 150 ng/mmol）的患者在24个月时放射学进展的风险较低[经人口统计学和关节间隙宽度调整后，比值比（95%置信区间）：0.57（0.39-0.85）]。在基线和6个月时CTX-II水平均较低的患者中观察到进展风险最低[比值比0.36（0.21-0.63）]。NTX-I水平和放射学进展之间没有显着关联observed.Conclusion：CTX-II与利塞膦酸钠降低膝关节OA患者和水平后6个月达到与放射学进展在24个月。在开始治疗后6个月监测软骨降解的标志物可能对识别低进展患者具有指导意义。(C)2007年国际骨关节炎研究学会。由爱思唯尔有限公司出版。保留所有权利。
Objective: To investigate whether early changes in biochemical markers of bone (NTX-1) and cartilage (CTX-II [C-terminal crosslinking telopeptide of type II collagen]) degradation are associated with radiological progression in patients with knee osteoarthritis (OA) receiving risedronate.Design: Two thousand four hundred and eighty three patients with medial compartment knee OA were randomized in two 24-month studies in North America (NA) and European Union (EU). Studies evaluated risedronate 5 mg/day, 35 mg/week (EU), 50 mg/week (NA), and 15 mg/day (NA and EU), compared to placebo in reducing signs and symptoms and in slowing radiographic progression. One thousand eight hundred and eighty five patients from the pooled EU and NA studies with available NTX-I/CTX-II at both baseline and 6 months and radiographs at baseline and at 24 months were analyzed.Results: Risedronate produced a dose-dependent reduction of NTX-I and CTX-II observed at 6 months which continued up to 24 months. Patients who had CTX-II levels returned to low levels (< 150 ng/mmol creatinine) at 6 months had a lower risk of radiographic progression at 24 months than patients whose CTX-II levels were increased both at baseline and 6 months [odds-ratio (95% confidence interval): 0.57 (0.39-0.85) after adjustment for demographics and joint space width]. The lowest risk of progression was observed in patients who had low CTX-II levels both at baseline and at 6 months [odds-ratio 0.36 (0.21-0.63)]. No significant association between NTX-I levels and radiological progression was observed.Conclusion: CTX-II decreased with risedronate in patients with knee OA and levels reached after 6 months were associated with radiological progression at 24 months. Monitoring a marker of cartilage degradation 6 months after initiating treatment may be instructive in identifying patients with low progression. (C) 2007 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.