Summary

This study examined the effects of denosumab compared to bisphosphonates and vitamin D alone on muscle performance in patients with low BMD. While grip force improved in both the denosumab and bisphosphonate group, a superior increase in chair rising test force was observed in the denosumab group.

Introduction

The aim of this study was to investigate the effect of the anti-resorptive agent denosumab (Dmab) on upper and lower limb muscle performance compared to bisphosphonate (BP) treatment and vitamin D supplementation alone (i.e., basic therapy) in patients with low BMD.

Methods

This retrospective, propensity score-matched (sex, age, BMI, follow-up time) cohort study included 150 osteopenic or osteoporotic patients receiving basic (n = 60), BP (n = 30) or Dmab (n = 60) therapy. All patients underwent a musculoskeletal assessment at baseline and follow-up, including DXA, laboratory bone metabolism parameters, grip force, and chair rising test mechanography. Mean annual percentage changes were calculated and compared between study groups.

Results

After a mean follow-up period of 17.6 ± 9.0 months, a significantly higher increase in grip force in both the Dmab (p < 0.001) and BP group (p = 0.001) compared to the vitamin D group was observed (vitamin D = − 6.1 ± 10.2%; BP = + 0.8 ± 8.2%; Dmab = + 5.1 ± 25.5%). The Dmab group showed a significantly higher increase in chair rising test force compared to the BP group (vitamin D = + 5.8 ± 12.7%; BP = + 0.9 ± 8.6%; Dmab = + 8.2 ± 14.4%; Dmab vs. BP p = 0.03). Neither the changes in BMD nor in bone metabolic parameters were associated with changes in muscle performance.

Conclusion

Dmab resulted in increased muscle strength in the upper and lower limbs, indicating systemic rather than site-specific effects as compared to BP. Based on these findings, Dmab might be favored over other osteoporosis treatments in patients with low BMD and poor muscle strength.

中文翻译：

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狄诺塞麦对低 BMD 患者肌肉表现的有益影响：一项回顾性倾向评分匹配研究

概括

这项研究检查了地诺单抗与单独使用双膦酸盐和维生素 D 相比对低 BMD 患者肌肉性能的影响。虽然地诺单抗组和双膦酸盐组的握力都有所改善，但在地诺单抗组中观察到椅子起立试验力的显着增加。

介绍

本研究的目的是研究与双膦酸盐 (BP) 治疗和单独补充维生素 D（即基础治疗）相比，抗再吸收剂狄诺塞麦 (Dmab) 对低 BMD 患者上肢和下肢肌肉性能的影响.

方法

这项回顾性、倾向评分匹配（性别、年龄、BMI、随访时间）队列研究包括 150 名接受基础（n  = 60）、BP（n  = 30）或 Dmab（n  = 60）治疗的骨质减少或骨质疏松患者。所有患者在基线和随访时都接受了肌肉骨骼评估，包括 DXA、实验室骨代谢参数、握力和椅子起立测试机械图。计算研究组之间的平均年度百分比变化并进行比较。

结果

在平均随访 17.6 ± 9.0 个月后， 观察到与维生素 D 组相比， Dmab ( p  < 0.001) 和 BP 组 ( p = 0.001) 的握力显着增加（维生素 D = - 6.1 ± 10.2%；BP = + 0.8 ± 8.2%；Dmab = + 5.1 ± 25.5%)。与 BP 组相比，Dmab 组的椅子上升试验力显着增加（维生素 D = + 5.8 ± 12.7%；BP = + 0.9 ± 8.6%；Dmab = + 8.2 ± 14.4%；Dmab 与 BP p  = 0.03）。BMD 和骨代谢参数的变化都与肌肉性能的变化无关。

结论

Dmab 导致上肢和下肢的肌肉力量增加，表明与 BP 相比是系统性而非特定部位的影响。基于这些发现，对于 BMD 低和肌肉力量差的患者，Dmab 可能比其他骨质疏松症治疗更受欢迎。