Effects of strontium ranelate on spinal osteoarthritis progression
Effects of strontium ranelate on spinal osteoarthritis progression
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DOI：
10.1136/ard.2007.075572
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发表时间：
2008-03-01
影响因子：
27.4
通讯作者：
Reginster, J-Y
中科院分区：
文献类型：
--
作者：
Bruyere, O.;Delferriere, D.;Reginster, J-Y
目的：本研究的目的是确定雷奈酸锶治疗3年是否可以延缓脊椎骨关节炎(OA)的进展。方法：本研究是对1105名骨质疏松症和伴随的放射性脊椎骨关节炎患者进行的脊柱骨质疏松治疗干预(SOTI)和外周骨质疏松的治疗(TROPOS)试验的汇总数据的事后分析，这些妇女在基线和3年治疗期间都有腰椎X光片。根据一种有效的方法对腰椎间隙骨赘、椎间隙变窄和硬化的存在和严重程度进行分级，并计算每个椎间隙的总体OA评分。在基线和3年后评估背痛(仅在SOTI中按5分Likert量表测量)和与健康相关的生活质量(SF-36问卷)。结果：与安慰剂组相比，雷奈酸锶治疗组脊柱整体骨性关节炎评分恶化的比例降低了42%(RR，0.58%；95%CI，0.42to0.79；p=0.0005)。与安慰剂组相比，雷奈酸锶治疗组患者3年后腰背痛明显改善(p=0.03)，但在与健康相关的生活质量方面，两组患者之间并无显著差异。结论：雷奈酸锶治疗骨质疏松症和脊柱骨关节炎盛行的女性患者的脊椎骨性关节炎的影像特征和腰背痛的进展。
Objective: The aim of this study was to determine whether a 3-year treatment with strontium ranelate could delay the progression of spinal osteoarthritis (OA).Methods: This study was a post-hoc analysis of pooled data from the Spinal Osteoporosis Therapeutic Intervention (SOTI) and TReatment Of Peripheral OSteoporosis (TROPOS) trials performed on 1105 women with osteoporosis and concomitant radiological spinal OA at baseline, and for whom lumbar x-rays were available at baseline and over the 3-year treatment period. The presence and severity of osteophytes, disc space narrowing and sclerosis in the lumbar intervertebral spaces was graded according to a validated method, and an overall OA score was calculated for each intervertebral space. Back pain (measured on a five-point Likert scale only in SOTI) and health-related quality of life (SF-36 questionnaire) were assessed at baseline and after 3 years. Patients who suffered an incident or progressive vertebral fracture during the study were excluded from the analysis.Results: The proportion of patients with worsening overall spinal OA score was reduced by 42% in the strontium ranelate group, compared with placebo (RR, 0.58; 95% CI, 0.42 to 0.79; p= 0.0005). Significantly more patients in the strontium ranelate group experienced an improvement in back pain after 3 years, compared with placebo (p= 0.03), while no significant difference was observed in terms of health-related quality of life between these patient groups.Conclusions: The results of this post-hoc analysis suggest that strontium ranelate could reduce the progression of the radiographic features of spinal OA and back pain in women with osteoporosis and prevalent spinal OA.