Summary

In this retrospective study, the effectiveness of short-term teriparatide with denosumab in reducing fragility fracture risk was determined in comparison with denosumab monotherapy. Administration of sequential teriparatide with denosumab showed excellent outcomes in suppressing the risk for fragility fractures compared with denosumab monotherapy.

Introduction

To determine the effectiveness of short-term teriparatide with denosumab in reducing the risk of fragility fractures in comparison to denosumab monotherapy.

Methods

The data of postmenopausal patients treated with denosumab for > 2 years between August 2015 and October 2020 were retrospectively analyzed. One hundred sixty four postmenopausal women of a total 615 were excluded, since they did not undergo > 2 bone mineral density (BMD) tests, were lost to follow-up, or received long-term teriparatide therapy. Total 320 patients received denosumab monotherapy and 131 patients received teriparatide for ≥ 3 months followed by denosumab. The number of osteoporotic fractures, presence of back pain before and after treatment, and annual BMD during treatment were comparatively assessed using t-test, Chi-square test, and linear mixed model analysis.

Results

Before treatment, the denosumab monotherapy group had fewer osteoporotic fractures (mean ± standard deviation; 0.459 ± 0.689) than the sequential therapy group had (1.037 ± 0.871; p < 0.001). After treatment, the sequential therapy group had fewer osteoporotic fractures than the denosumab monotherapy group had (0.119 ± 0.348 versus 0.144 ± 0.385; p < 0.001). At 1 and 2 years after treatment, the increase in lumbar spine BMD was greater in the sequential therapy group than in the denosumab monotherapy group (p = 0.08, group × time). The difference between post and pre-treatment back pain visual analog scale score was significantly lower in the sequential therapy group than in the monotherapy group (3.246 ± 3.426 versus 1.734 ± 3.049; p < 0.001).

Conclusion

Short-term teriparatide use before denosumab showed excellent outcomes in suppressing the risk of fragility fractures compared with denosumab monotherapy.

中文翻译：

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特立帕肽序贯治疗与地诺单抗与地诺单抗单药治疗降低脆性骨折风险的疗效比较

概括

在这项回顾性研究中，与狄诺塞麦单药治疗相比，确定了短期特立帕肽联合狄诺塞麦在降低脆性骨折风险方面的有效性。与狄诺塞麦单药治疗相比，连续使用特立帕肽联合狄诺塞麦在抑制脆性骨折风险方面表现出优异的结果。

介绍

确定与狄诺塞麦单药治疗相比，短期特立帕肽联合狄诺塞麦在降低脆性骨折风险方面的有效性。

方法

回顾性分析2015年8月至2020年10月间接受狄诺塞麦治疗>2年的绝经后患者资料。总共 615 名绝经后妇女中的 164 名被排除在外，因为她们没有接受 > 2 次骨矿物质密度 (BMD) 测试、失访或接受长期特立帕肽治疗。共有 320 名患者接受了地诺单抗单药治疗，131 名患者接受了 ≥ 3 个月的特立帕肽，随后接受了地诺单抗治疗。采用t检验、卡方检验和线性混合模型分析比较评价骨质疏松性骨折数、治疗前后有无腰痛、治疗期间年BMD 。

结果

治疗前，狄诺塞麦单药治疗组的骨质疏松性骨折（平均值±标准差；0.459±0.689）少于序贯治疗组（1.037±0.871；p  < 0.001）。治疗后，序贯治疗组的骨质疏松性骨折少于地诺单抗单药治疗组（0.119 ± 0.348 vs 0.144 ± 0.385；p  < 0.001）。在治疗后 1 年和 2 年，序贯治疗组的腰椎 BMD 增加大于狄诺塞麦单药治疗组（p  = 0.08，组 × 时间）。序贯治疗组治疗后和治疗前背痛视觉模拟量表评分的差异显着低于单药治疗组（3.246 ± 3.426 vs 1.734 ± 3.049；p < 0.001)。

结论

与狄诺塞麦单药治疗相比，狄诺塞麦之前短期使用特立帕肽在抑制脆性骨折风险方面表现出优异的效果。