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Real-life effects of pharmacological osteoporosis treatments on bone mineral density by quantitative computed tomography.
Boehm, Elena; Sauer, Christina; Baur-Melnyk, Andrea; Biebl, Johanna Theresia; Harada, Saori; Wegener, Bernd; Kraft, Eduard; Stahl, Robert; Feist-Pagenstert, Isa.
Afiliación
  • Boehm E; Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Marchioninistraße 15, 81377, Munich, Germany. elena.boehm@med.uni-muenchen.de.
  • Sauer C; Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Faculty of Medicine, LMU Munich, Marchioninistraße 15, 81377, Munich, Germany.
  • Baur-Melnyk A; Department of Radiology, University Hospital, LMU Munich, Marchioninistraße 15, 81377, Munich, Germany.
  • Biebl JT; Radiologische Praxis Divocare, Kaufingerstrasse 15, 80331, Munich, Germany.
  • Harada S; Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Marchioninistraße 15, 81377, Munich, Germany.
  • Wegener B; Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Marchioninistraße 15, 81377, Munich, Germany.
  • Kraft E; Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Faculty of Medicine, LMU Munich, Pettenkofer School of Public Health, Marchioninistraße 15, 81377, Munich, Germany.
  • Stahl R; Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Marchioninistraße 15, 81377, Munich, Germany.
  • Feist-Pagenstert I; Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Marchioninistraße 15, 81377, Munich, Germany.
J Bone Miner Metab ; 2024 Sep 17.
Article en En | MEDLINE | ID: mdl-39287797
ABSTRACT

INTRODUCTION:

Monitoring of bone mineral density (BMD) is used to assess pharmacological osteoporosis therapy. This study examined the real-life effects of antiresorptive and osteoanabolic treatments on volumetric BMD (vBMD) of the spine by quantitative computed tomography (QCT). MATERIALS AND

METHODS:

Patients aged ≥ 50 years with a vBMD < 120 mg/ml had ≥ 2 QCT. For analysis of therapy effects, the pharmacological treatment and the duration of each therapy were considered. Identical vertebrae were evaluated in all vBMD measurements for each patient. A linear mixed model with random intercepts was used to estimate the effects of pharmacological treatments on vBMD.

RESULTS:

A total of 1145 vBMD measurements from 402 patients were analyzed. Considering potential confounders such as sex, age, and prior treatment, a reduction in trabecular vBMD was estimated for oral bisphosphonates (- 1.01 mg/ml per year; p < 0.001), intravenous bisphosphonates (- 0.93 mg/ml per year; p = 0.015) and drug holiday (- 1.58 mg/ml per year; p < 0.001). Teriparatide was estimated to increase trabecular vBMD by 4.27 mg/ml per year (p = 0.018). Patients receiving denosumab showed a statistically non-significant decrease in trabecular vBMD (- 0.44 mg/ml per year; p = 0.099). Compared to non-treated patients, pharmacological therapy had positive effects on trabecular vBMD (1.35 mg/ml; p = 0.001, 1.43 mg/ml; p = 0.004, 1.91 mg/ml; p < 0.001, and 6.63 mg/ml; p < 0.001 per year for oral bisphosphonates, intravenous bisphosphonates, denosumab, and teriparatide, respectively).

CONCLUSION:

An increase in trabecular vBMD by QCT was not detected with antiresorptive agents. Patients treated with teriparatide showed increasing trabecular vBMD. Non-treatment led to a larger decrease in trabecular vBMD than pharmacological therapy.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Bone Miner Metab Asunto de la revista: METABOLISMO Año: 2024 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Japón
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Bone Miner Metab Asunto de la revista: METABOLISMO Año: 2024 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Japón