地舒单抗对绝经后骨质疏松症女性的小梁骨评分的影响。
Effect of denosumab on trabecular bone score in postmenopausal women with osteoporosis.
机构信息
Oregon Osteoporosis Center, Portland, OR, USA.
Institute for Health and Ageing, Australian Catholic University, Melbourne, Australia.
出版信息
Osteoporos Int. 2017 Oct;28(10):2967-2973. doi: 10.1007/s00198-017-4140-y. Epub 2017 Jul 26.
UNLABELLED
Trabecular bone score (TBS) assesses bone quality in the lumbar spine using dual-energy X-ray absorptiometry (DXA) scans. In postmenopausal women with osteoporosis, denosumab significantly improved TBS independently of bone mineral density (BMD). This practical technique may have a role in managing patients with osteoporosis.
INTRODUCTION
TBS, a gray-level texture index determined from lumbar spine DXA scans, correlates with bone microarchitecture and enhances assessment of vertebral fracture risk independently of BMD. In the FREEDOM study, denosumab increased BMD and reduced new vertebral fractures in postmenopausal women with osteoporosis. This retrospective analysis explored the effect of denosumab on TBS and the association between TBS and BMD in FREEDOM.
METHODS
Postmenopausal women with lumbar spine or total hip BMD T-score <-2.5 and -4.0 or higher at both sites received placebo or denosumab 60 mg subcutaneously every 6 months. TBS indices were determined from DXA scans at baseline and months 12, 24, and 36 in a subset of 285 women (128 placebo, 157 denosumab) who had TBS values at baseline and ≥1 postbaseline visit.
RESULTS
Baseline characteristics were comparable between treatment groups; mean (SD) lumbar spine BMD T-score was -2.79 (0.64), and mean (standard deviation [SD]) TBS was 1.200 (0.101) overall. In the placebo group, BMD and TBS increased by ≤0.2% or decreased from baseline at each visit. In the denosumab group, progressive increases from baseline at 12, 24, and 36 months were observed for BMD (5.7, 7.8, and 9.8%) and TBS (1.4, 1.9, and 2.4%). Percentage changes in TBS were statistically significant compared with baseline (p < 0.001) and placebo (p ≤ 0.014). TBS was largely unrelated to BMD, regardless of treatment, either at baseline or for annual changes from baseline (all r ≤ 0.06).
CONCLUSIONS
In postmenopausal women with osteoporosis, denosumab significantly improved TBS independently of BMD.
目的
骨小梁评分（TBS）使用双能 X 射线吸收法（DXA）扫描评估腰椎的骨质量。在骨质疏松症的绝经后妇女中，地舒单抗可独立于骨密度（BMD）显著改善 TBS。这种实用技术可能在骨质疏松症患者的管理中发挥作用。
简介
TBS 是一种从腰椎 DXA 扫描中确定的灰度纹理指数，与骨微观结构相关，可增强对椎体骨折风险的评估，而与 BMD 无关。在 FREEDOM 研究中，地舒单抗增加了骨质疏松症绝经后妇女的 BMD 并减少了新的椎体骨折。这项回顾性分析探讨了地舒单抗对 TBS 的影响以及 TBS 与 FREEDOM 中 BMD 的关系。
方法
腰椎或全髋 BMD T 评分 <-2.5 和 -4.0 或两个部位均为更高的绝经后妇女接受安慰剂或地舒单抗 60mg 皮下每 6 个月一次。在基线时有 TBS 值且至少有 1 次基线后访视的 285 名女性（128 名安慰剂，157 名地舒单抗）的子集中，从 DXA 扫描中确定 TBS 指数。
结果
治疗组之间的基线特征相似；平均（标准差）腰椎 BMD T 评分分别为-2.79（0.64），平均（标准偏差[SD]）TBS 为 1.200（0.101）。在安慰剂组中，每次就诊时，BMD 和 TBS 的增加均≤0.2%或从基线下降。在地舒单抗组中，在 12、24 和 36 个月时观察到 BMD（5.7、7.8 和 9.8%）和 TBS（1.4、1.9 和 2.4%）从基线开始的逐渐增加。与基线相比（p <0.001）和安慰剂（p≤0.014），TBS 的百分比变化具有统计学意义。无论治疗如何，TBS 与 BMD 的相关性均不大，无论是基线时还是从基线的年度变化（所有 r ≤0.06）。
结论
在骨质疏松症的绝经后妇女中，地舒单抗可独立于 BMD 显著改善 TBS。
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