Comparative effects of teriparatide and ibandronate on spine bone mineral density (BMD) and microarchitecture (TBS) in postmenopausal women with osteoporosis: a 2-year open-label study
Comparative effects of teriparatide and ibandronate on spine bone mineral density (BMD) and microarchitecture (TBS) in postmenopausal women with osteoporosis: a 2-year open-label study
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DOI：
10.1007/s00198-014-2703-8
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发表时间：
2014-07-01
影响因子：
4
通讯作者：
Lippuner, K.
中科院分区：
文献类型：
--
作者：
Senn, C.;Guenther, B.;Lippuner, K.
采用腰椎骨密度（BMD）和骨小梁评分（TBS），比较了特立哌酮与伊班膦酸钠治疗绝经后骨质疏松症妇女2年以上的疗效。与伊班膦酸盐相比，特立帕鲁肽诱导BMD和TBS的增加更大，这表明骨合成药物对骨微结构的影响更明显。骨小梁评分（TBS）是骨微结构的指数，与骨矿物质密度（BMD）无关，通过前后位脊柱双X射线吸收测定法（DXA）扫描计算。TBS监测骨活性物质治疗反应的潜在作用尚未确定。本研究的目的是比较重组人1-34甲状旁腺素的作用（特立帕酮）和双膦酸盐伊班膦酸盐（IBN）对绝经后骨质疏松妇女腰椎（LS）BMD和TBS的影响。两组患者年龄、体重指数（BMI）和基线LS BMD匹配，在2年期间每天皮下注射特立哌齐（N = 65）或每季度静脉注射IBN（N = 122），并比较基线和治疗开始后2年的LS BMD测量结果。在年龄67.9 +/- 7.4岁、体重指数23.8 +/- 3.8 kg/m2、BMD L1-L4 0.741 +/- 0.100 g/cm 2和TBS 1.208 +/- 0.100方面，两组之间相似。在24个月内，特立帕鲁肽诱导LS BMD和TBS的增加显著大于IBN（分别为+7.6%+/- 6.3 vs.+2.9%+/- 3.3和+4.3%+/- 6.6 vs.+0.3%+/- 4.1;两者均P < 0.0001）。LS BMD和TBS仅在基线时弱相关（r（2）= 0.04），24个月内BMD和TBS变化之间无相关性。在绝经后骨质疏松症妇女中，特立哌齐治疗2年导致LS BMD和TBS显著增加，高于IBN，表明特立哌齐对骨微结构的影响比IBN更显著。
Treatment effects over 2 years of teriparatide vs. ibandronate in postmenopausal women with osteoporosis were compared using lumbar spine bone mineral density (BMD) and trabecular bone score (TBS). Teriparatide induced larger increases in BMD and TBS compared to ibandronate, suggesting a more pronounced effect on bone microarchitecture of the bone anabolic drug.The trabecular bone score (TBS) is an index of bone microarchitecture, independent of bone mineral density (BMD), calculated from anteroposterior spine dual X-ray absorptiometry (DXA) scans. The potential role of TBS for monitoring treatment response with bone-active substances is not established. The aim of this study was to compare the effects of recombinant human 1-34 parathyroid hormone (teriparatide) and the bisphosphonate ibandronate (IBN), on lumbar spine (LS) BMD and TBS in postmenopausal women with osteoporosis.Two patient groups with matched age, body mass index (BMI), and baseline LS BMD, treated with either daily subcutaneous teriparatide (N = 65) or quarterly intravenous IBN (N = 122) during 2 years and with available LS BMD measurements at baseline and 2 years after treatment initiation were compared.Baseline characteristics (overall mean +/- SD) were similar between groups in terms of age 67.9 +/- 7.4 years, body mass index 23.8 +/- 3.8 kg/m(2), BMD L1-L4 0.741 +/- 0.100 g/cm(2), and TBS 1.208 +/- 0.100. Over 24 months, teriparatide induced a significantly larger increase in LS BMD and TBS than IBN (+7.6 % +/- 6.3 vs. +2.9 % +/- 3.3 and +4.3 % +/- 6.6 vs. +0.3 % +/- 4.1, respectively; P < 0.0001 for both). LS BMD and TBS were only weakly correlated at baseline (r (2) = 0.04) with no correlation between the changes in BMD and TBS over 24 months.In postmenopausal women with osteoporosis, a 2-year treatment with teriparatide led to a significantly larger increase in LS BMD and TBS than IBN, suggesting that teriparatide had more pronounced effects on bone microarchitecture than IBN.