골감소증에서 사용된 연 1회 정주용 졸레드론산의 효과
Efficacy of Once-Yearly Intravenous Zoledronic Acid for Osteopenia
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Objectives: To assess the clinical efficacy of once-yearly treatment with Zoledronic acid in patients with osteopenia. Materials and Methods: From June 2009 to November 2011, patients diagnosed with osteopenia were applied to fracture risk assessment tool (FRAX). Among them, 40 patients who showed high possibility of osteoporotic fracture were selected and treated with intravenous zoledronic acid once-yearly. At the baseline and after one year of injection of zoledronate, we measured the changes in the bone mineral density (BMD) and bone turnover markersIn addition, we analyzed the side effects and thereby assessed the drug safety. Results: Mean 10 year probability of fracture calculated by FRAX tool was 4.2±1.8% for hip fracture, and 17.7±4.3% for other major osteoporotic fracture. Mean T-score was -1.89±0.42 at baseline and -1.71±±0.54 at 1 year after treatment. But this differences did not reachstatistical significance (P>0.05). Mean C-telopeptide levels were 0.35±±0.32 ng/mL and 0.22±±0.16 ng/mL, , mean osteocalcin levels were 13.64±5.15 ng/mL and 11.7±6.02 ng/mL before and after treatment. These differences reached a statistical significance (P<0.001). During the treatment, there were no serious adverse effects. Conclusions: Once-yearly treatment with Zoledronic acid was effective in reducing bone resorption in patients with osteopenia. In addition, the BMD levels were slightly increased. But this was not statistically significant. Further long-term follow-up studies are warranted to assess the efficacy of a once-yearly treatment with Zoledronic acid in patients with osteopenia.
Abstract
Objectives: To assess the clinical efficacy of once-yearly treatment with Zoledronic acid in patients with osteopenia. Materials and Methods: From June 2009 to November 2011, patients diagnosed with osteopenia were applied to fracture risk assessment tool (FRAX). Among them, 40 patients who showed high possibility of osteoporotic fracture were selected and treated with intravenous zoledronic acid once-yearly. At the baseline and after one year of injection of zoledronate, we measured the changes in the bone mineral density (BMD) and bone turnover markersIn addition, we analyzed the side effects and thereby assessed the drug safety. Results: Mean 10 year probability of fracture calculated by FRAX tool was 4.2±1.8% for hip fracture, and 17.7±4.3% for other major osteoporotic fracture. Mean T-score was -1.89±0.42 at baseline and -1.71±±0.54 at 1 year after treatment. But this differences did not reachstatistical significance (P>0.05). Mean C-telopeptide levels were 0.35±±0.32 ng/mL and 0.22±±0.16 ng/mL, , mean osteocalcin levels were 13.64±5.15 ng/mL and 11.7±6.02 ng/mL before and after treatment. These differences reached a statistical significance (P<0.001). During the treatment, there were no serious adverse effects. Conclusions: Once-yearly treatment with Zoledronic acid was effective in reducing bone resorption in patients with osteopenia. In addition, the BMD levels were slightly increased. But this was not statistically significant. Further long-term follow-up studies are warranted to assess the efficacy of a once-yearly treatment with Zoledronic acid in patients with osteopenia.
참고문헌 (20)
- Anonymous, "Consensus development conference: diagnosis, prophylaxis, and treatment of osteoporosis", Am J Med, 94, pp.64~50 (1993)
- Kanis JA, "FRAX and its applications to clinical practice", Bone, 44, pp.734~743 (2009)
- Erik FE, "Treatment of osteopenia", Rev Endocr Metab Disord, 13, pp.209~223 (2012)
- Black DM, "Once-yearly zoledronic acid for treatment of postmenopausal osteoporosis", N Engl J Med, 356, pp.1809~1822 (2007)
- Lyles KW, "Zoledronic acid reduces clinical fractures and mortality after hip fracture", N Engl J Med, 357, pp.1799~1809 (2007)
- Looker AC, "Prevalence of low femoral bone density in older U.S. adults from NHANES III", J Bone Miner Res, 12, pp.1761~1768 (1997)
- Rees MCP, "The need to improve compliance to HRT", British Journal of Obstetrics and Gynecology, 104, pp.1~3 (1997)
- Siris ES, "Bone mineral density thresholds for pharmacological intervention to prevent fractures", Arch Intern Med, 164, pp.1108~1112 (2004)
- Schousboe JT, "Cost-effectiveness of alendronate therapy for osteopenic postmenopausal women", Ann Intern Med, 142, pp.734~741 (2005)
- McClung M, "Zoledronic acid for the prevention of bone loss in postmenopausal women with low bone mass", Obstet Gynecol, 114, pp.999~1007 (2009)
- Ensrud KE, "Prevalent vertebral deformities predict mortality and hospitalization in older women with low bone mass. Fracture intervention trial research group", J Am Geriatr Soc, 48, pp.241~249 (2000)
- Johnell O, "Mortality after osteoporotic fractures", Osteoporos Int, 15, pp.38~42 (2004)
- Quandt SA, "Fracture Intervention Trial Research Group. Effect of alendronate on vertebral fracture risk in women with bone mineral density T scores of -1.6 to -2.5 at the femoral neck: the fracture intervention trial", Mayo Clinic Proc, 80, pp.343~349 (2005)
- Black DM, "Effect of once-yearly infusion of zoledronic acid 5 mg on spine and hip fracture reduction in postmenopausal women with osteoporosis: the HORIZON pivotal fracture trial", Arthritis Rheum, 54, pp.S305~ (2006)
- Cummings SR, "Effect of alendronate on risk of fracture in women with low bone density but without vertebral fractures: results from the Fracture Intervention Trial", JAMA, 280, pp.2077~2082 (1998)
- Kanis JA., "Diagnosis of osteoporosis and assessment of fracture risk", Lancet, 359, pp.1929~1936 (2002)
- Chesnut CH 3rd, "Hormone replacement therapy in postmenopausal women: urinary N-telopeptide of type I collagen monitors therapeutic effect and predicts response of bone mineral density", Am J Med, 102, pp.29~37 (1997)
- el-Hajj Fuleihan G, "Effect of sequential and daily continuous hormone replacement therapy on indexes of mineral metabolism", Arch Intern Med, 152, pp.1904~1909 (1992)
- Ravn P, "Biochemical markers can predict the response in bone mass during alendronate treatment in early postmenopausal women. Alendronate Osteoporosis Prevention Study Group", Bone, 24, pp.237~244 (1999)