J Bone Miner Res:近期股骨转子间骨折的老年患者:特立帕肽vs利塞膦酸钠

2017-06-30 选题审校:门鹏 编辑:吴刚 环球医学

2017年5月,发表在《J Bone Miner Res》的一项由西班牙、意大利、墨西哥等国科学家进行的78周随机临床试验的最终结果表明,近期股骨转子间骨折的老年患者中,特立帕肽比利塞膦酸钠更有效。

2017年5月,发表在《J Bone Miner Res》的一项由西班牙、意大利、墨西哥等国科学家进行的78周随机临床试验的最终结果表明,近期股骨转子间骨折的老年患者中,特立帕肽比利塞膦酸钠更有效。

研究人员旨在呈现一项比较股骨转子间骨折手术后2周内开始特立帕肽20μg/d(QD)和利塞膦酸钠35mg/周(QW)治疗的研究的最终结果。

BMD T得分≤-2.0和25OHD水平≥9.2ngmL的患者被随机分配到26周的双模拟治疗+钙和维生素D的组中,接着进行52周的相同分配的活性药物的开放标签治疗。首要终点为腰椎(LS)BMD自基线到78周时的改变。次要终点和探索性终点为股骨近端BMD的改变、功能、髋部疼痛[Charnley评分和100mm视觉模拟量表(VAS)]、生活质量(简表-36)、放射学结局、安全性。使用重复测量的混合模型(MMRM)和逻辑回归分析数据。

总计,224名患者被随机分组:171人(特立帕肽86人)进行了有效性分析(平均±SD年龄:77±7.7岁,77%为女性)。平均基线LS、股骨颈(FN)和总髋关节(TH)T得分分别为-2.16、-2.63和-2.51。78周时,与利塞膦酸钠相比,特立帕肽组的患者,其LS(+11.08% vs +6.45%;P<0.001)和FN(+1.96% vs -1.19%;P=0.003)的BMD显着性增加更多,TH BMD的组间差异无显着性。6、12、18和26周时,特立帕肽组的患者起立-行走计时测试(TUG)显着性更快(差异:-3.2~-5.9s;总体差异的P=0.045)。TUG测试期间,特立帕肽组的患者18周时100mmVAS的髋部疼痛显着性低(调整差异:-11.3mm,P=0.033;12和26周时为-10.0和-9.3;总体差异的P=0.079)。其他次要结局和探索性结局无差异。特立帕肽组有2例新发髋部骨折,利塞膦酸钠组有7例(P=0.171),并且特立帕肽组具有更频繁的高钙血症和高尿酸血症。

总之,与利塞膦酸钠相比,78周的特立帕肽治疗表现出显着性高的LS和FN BMD增加、较少的疼痛和更快速的TUG测试。

原始出处:

版权声明:
本网站所有内容来源注明为“williamhill asia 医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于williamhill asia 医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“williamhill asia 医学”。其它来源的文章系转载文章,或“williamhill asia 号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与williamhill asia 联系,williamhill asia 将立即进行删除处理。
在此留言
评论区 (4)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1915156, encodeId=ffe919151562d, content=<a href='/topic/show?id=05343619cf' target=_blank style='color:#2F92EE;'>#Bone#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3619, encryptionId=05343619cf, topicName=Bone)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7dc7399, createdName=apoenzyme, createdTime=Sat Nov 11 17:02:00 CST 2017, time=2017-11-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1813622, encodeId=919918136229d, content=<a href='/topic/show?id=cea39333468' target=_blank style='color:#2F92EE;'>#转子间#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93334, encryptionId=cea39333468, topicName=转子间)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Sun Jul 02 10:02:00 CST 2017, time=2017-07-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1529682, encodeId=080c15296821d, content=<a href='/topic/show?id=70ff81e9156' target=_blank style='color:#2F92EE;'>#股骨#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81791, encryptionId=70ff81e9156, topicName=股骨)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9d3011964327, createdName=wangyang7962, createdTime=Sun Jul 02 00:02:00 CST 2017, time=2017-07-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1588685, encodeId=9c901588685f1, content=<a href='/topic/show?id=f31e680240e' target=_blank style='color:#2F92EE;'>#特立帕肽#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=68024, encryptionId=f31e680240e, topicName=特立帕肽)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a75d17610690, createdName=yyj068, createdTime=Sun Jul 02 00:02:00 CST 2017, time=2017-07-02, status=1, ipAttribution=)]
    2017-11-11 apoenzyme
  2. [GetPortalCommentsPageByObjectIdResponse(id=1915156, encodeId=ffe919151562d, content=<a href='/topic/show?id=05343619cf' target=_blank style='color:#2F92EE;'>#Bone#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3619, encryptionId=05343619cf, topicName=Bone)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7dc7399, createdName=apoenzyme, createdTime=Sat Nov 11 17:02:00 CST 2017, time=2017-11-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1813622, encodeId=919918136229d, content=<a href='/topic/show?id=cea39333468' target=_blank style='color:#2F92EE;'>#转子间#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93334, encryptionId=cea39333468, topicName=转子间)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Sun Jul 02 10:02:00 CST 2017, time=2017-07-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1529682, encodeId=080c15296821d, content=<a href='/topic/show?id=70ff81e9156' target=_blank style='color:#2F92EE;'>#股骨#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81791, encryptionId=70ff81e9156, topicName=股骨)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9d3011964327, createdName=wangyang7962, createdTime=Sun Jul 02 00:02:00 CST 2017, time=2017-07-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1588685, encodeId=9c901588685f1, content=<a href='/topic/show?id=f31e680240e' target=_blank style='color:#2F92EE;'>#特立帕肽#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=68024, encryptionId=f31e680240e, topicName=特立帕肽)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a75d17610690, createdName=yyj068, createdTime=Sun Jul 02 00:02:00 CST 2017, time=2017-07-02, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=1915156, encodeId=ffe919151562d, content=<a href='/topic/show?id=05343619cf' target=_blank style='color:#2F92EE;'>#Bone#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3619, encryptionId=05343619cf, topicName=Bone)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7dc7399, createdName=apoenzyme, createdTime=Sat Nov 11 17:02:00 CST 2017, time=2017-11-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1813622, encodeId=919918136229d, content=<a href='/topic/show?id=cea39333468' target=_blank style='color:#2F92EE;'>#转子间#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93334, encryptionId=cea39333468, topicName=转子间)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Sun Jul 02 10:02:00 CST 2017, time=2017-07-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1529682, encodeId=080c15296821d, content=<a href='/topic/show?id=70ff81e9156' target=_blank style='color:#2F92EE;'>#股骨#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81791, encryptionId=70ff81e9156, topicName=股骨)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9d3011964327, createdName=wangyang7962, createdTime=Sun Jul 02 00:02:00 CST 2017, time=2017-07-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1588685, encodeId=9c901588685f1, content=<a href='/topic/show?id=f31e680240e' target=_blank style='color:#2F92EE;'>#特立帕肽#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=68024, encryptionId=f31e680240e, topicName=特立帕肽)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a75d17610690, createdName=yyj068, createdTime=Sun Jul 02 00:02:00 CST 2017, time=2017-07-02, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=1915156, encodeId=ffe919151562d, content=<a href='/topic/show?id=05343619cf' target=_blank style='color:#2F92EE;'>#Bone#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3619, encryptionId=05343619cf, topicName=Bone)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7dc7399, createdName=apoenzyme, createdTime=Sat Nov 11 17:02:00 CST 2017, time=2017-11-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1813622, encodeId=919918136229d, content=<a href='/topic/show?id=cea39333468' target=_blank style='color:#2F92EE;'>#转子间#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93334, encryptionId=cea39333468, topicName=转子间)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Sun Jul 02 10:02:00 CST 2017, time=2017-07-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1529682, encodeId=080c15296821d, content=<a href='/topic/show?id=70ff81e9156' target=_blank style='color:#2F92EE;'>#股骨#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81791, encryptionId=70ff81e9156, topicName=股骨)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9d3011964327, createdName=wangyang7962, createdTime=Sun Jul 02 00:02:00 CST 2017, time=2017-07-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1588685, encodeId=9c901588685f1, content=<a href='/topic/show?id=f31e680240e' target=_blank style='color:#2F92EE;'>#特立帕肽#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=68024, encryptionId=f31e680240e, topicName=特立帕肽)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a75d17610690, createdName=yyj068, createdTime=Sun Jul 02 00:02:00 CST 2017, time=2017-07-02, status=1, ipAttribution=)]

相关威廉亚洲官网

转子间骨折髓内钉主钉置于股骨颈轴线中心力学强度更佳

    髓内钉是手术固定股骨转子间不稳定骨折的常见内置物。在髓内钉手术操作中,将拉力主钉放置于最佳位置非常重要。以往应用滑动钢板(SHS)治疗股骨转子间骨折时,控制好尖顶距(TAD,tip-apex distance)是防止固定失败的重要因素。但对于髓内钉固定,拉力主钉的最佳位置尚存有争议,有人认为拉力螺钉应该沿股骨头轴线置入,并尽量深的放置,也有人认为拉力螺钉应该放

JOT:转子间骨折愈合后不应常规去除髋部螺钉

股骨转子间骨折愈合后并非常规行内固定取出术,一般只在青少年患者、内固定松动疼痛、金属过敏、感染等情况下才进行内固定去除手术。近来有学者报道股骨转子间骨折愈合后去除内固定出现了同侧的股骨颈骨折。为了解这种股骨颈骨折的发生率,探讨造成这种股骨颈骨折的风险因素,韩国的Pil Whan Yoon教授进行了相关研究,结果发表在2013年12月的JOT杂志上。【原文下载】 患者及

JOT:长短髓内钉治疗股骨转子间骨折疗效无差异

随着人口老龄化以及骨质疏松的影响,股骨转子间骨折的患病率不断增加。目前,至少在美国,股骨转子周围骨折使用髓内钉者越来越多。与髓外固定相比,髓内装置在理论上具有生物力学方面的优势,尽管至今还没有充分的临床证据证实这一优势,但无论短髓内钉还是长髓内钉均有临床疗效良好的报道。 对于骨折线没有延及远端的股骨转子间骨折(AO分型31-A1和A2),临床上长短髓内钉均有应用,目前也没有研究对二者进行对比。而