알렌드로네이트의 복용 실태 및 투여 후 골밀도의 변화
Alendronate use and Changes in Bone Mineral Density
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목적:알렌드로네이트 투여 후 골밀도 변화와 연령 및 최초 골밀도에 따른 치료 효과, 지속도 및 부작용을 알아보았다. 대상 및 방법: 총 212명 중, 1년 이상 복용이 지속되지 못한 162명을 제외한 50명을 연구 내용에 포함하였고, 제외된 162명에 대하여 조기 중단의 이유를 조사하였다. 결과: 요추에서 매해7.2%, 3.4%, 2.0%, 0.9%, 근위대퇴부에서는 각각2.2%, 1.5%, -0.9%, 0.9%의 증가를 보였다. 60세 미 만에서는 2.1%(요추부), 3.4%(근위 대퇴부), 60세이상 70세 미만에서 6.3%, 0.5%, 70세 이상에서 2.9%, 1.2%의 골밀도 증 가가 있었다. 최초 T점수가 -4.0 미만에서 요추부 및 근위 대퇴부 각각 7.0%, 1.2%, -4.0 이상 -3.0 미만에서5.3%, 0.2%, - 3.0 이상에서 2.5%, 3.1%의 골밀도 증가를 보였다. 알렌드로네이트의 조기 중단 이유로는 복용의 번거로움, 경제적 이유, 부작 용 등이 있었다. 결론: 요추부에서 더 큰 골밀도 증가가 있었고, 첫해의 골밀도 증가가 가장 컷다. 나이에 따른 골밀도 변화는 별다른 상관 관계 가 없었으나, 요추부에서는 최초 골밀도가 낮을수록 골밀도는 더 증가하였다. 조기 치료 중단은 79.3%, 부작용 발현은 19.8% 였다.
Abstract
Purpose: To evaluate the changes in bone mineral density (BMD) after alendronate intake and to determine the side effects and patient compliance. Materials and Methods: Two hundred twelve patients with osteoporosis were treated with alendronate. One hundred sixty-two patients were excluded because of early discontinuation. Thus, 50 patients were included in the analysis. Results: The annual increase in BMD in patients taking alendronate was 7.2% (1st year), 3.4%, 2.0%, and 0.9% (4th year) in the L-spine, and 2.2%, 1.5%, -0.9%, and 0.9% in the femur. The changes in BMD of patients < 60 years of age were 2.1% in the L-spine and 3.4% in the femur. The BMD of patients between 60 and 69 years of age increased 6.3% and 0.5% in the L-spine and femur, respectively, and the BMD of patients >70 of age were 2.9% and 1.2% in the L-spine and femur, respectively. The BMD changes in patients with a T-score < -4.0 were 7.0% (L-spine) and 1.2% (femur), the BMD changes in patients with a T-score between -3.0 and -3.9 were 5.3% and 0.2% for the Lspine and femur, respectively, and the BMD changes in patients with a T-score > -3.0 were 2.5% and 3.1% for the Lspine and femur, respectively. The reasons for early discontinuation of alendronate were difficulty in intake, economic reasons, and adverse events. Conclusion: The BMD changes were greater in the L-spine than the femu in alendronate users. At the first year, the changes in BMD was greatest. There was no significant difference in BMD change according to age. In the Lspine, however, BMD changes were greater in the group with lower T-scores. The early discontinuance rate was 74%, and the adverse events rate was 19.8%.
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