Abstract：
OBJECTIVE: The purpose of this study was to determine the effect of osteoporosis medications on opportunistic CT-based Hounsfield units (HU).
METHODS: Spine and nonspine surgery patients were retrospectively identified who had been treated with romosozumab for 3 to 12 months, teriparatide for 3 to 12 months, teriparatide for > 12 months, denosumab for > 12 months, or alendronate for > 12 months. HU were measured in the L1-4 vertebral bodies. One-way ANOVA was used to compare the mean change in HU among the five treatment regimens.
RESULTS: In total, 318 patients (70% women) were included, with a mean age of 69 years and mean BMI of 27 kg/m2. There was a significant difference in mean HU improvement (p < 0.001) following treatment with romosozumab for 3 to 12 months (n = 32), teriparatide for 3 to 12 months (n = 30), teriparatide for > 12 months (n = 44), denosumab for > 12 months (n = 123), and alendronate for > 12 months (n = 100). Treatment with romosozumab for a mean of 10.5 months significantly increased the mean HU by 26%, from a baseline of 85 to 107 (p = 0.012). Patients treated with teriparatide for > 12 months (mean 23 months) experienced a mean HU improvement of 25%, from 106 to 132 (p = 0.039). Compared with the mean baseline HU, there was no significant difference after treatment with teriparatide for 3 to 12 months (110 to 119, p = 0.48), denosumab for > 12 months (105 to 107, p = 0.68), or alendronate for > 12 months (111 to 113, p = 0.80).
CONCLUSIONS: Patients treated with romosozumab for a mean of 10.5 months and teriparatide for a mean of 23 months experienced improved spinal bone mineral density as estimated by CT-based opportunistic HU. Given the shorter duration of effective treatment, romosozumab may be the preferred medication for optimization of osteoporotic patients in preparation for elective spine fusion surgery.
METHODS: Spine and nonspine surgery patients were retrospectively identified who had been treated with romosozumab for 3 to 12 months, teriparatide for 3 to 12 months, teriparatide for > 12 months, denosumab for > 12 months, or alendronate for > 12 months. HU were measured in the L1-4 vertebral bodies. One-way ANOVA was used to compare the mean change in HU among the five treatment regimens.
RESULTS: In total, 318 patients (70% women) were included, with a mean age of 69 years and mean BMI of 27 kg/m2. There was a significant difference in mean HU improvement (p < 0.001) following treatment with romosozumab for 3 to 12 months (n = 32), teriparatide for 3 to 12 months (n = 30), teriparatide for > 12 months (n = 44), denosumab for > 12 months (n = 123), and alendronate for > 12 months (n = 100). Treatment with romosozumab for a mean of 10.5 months significantly increased the mean HU by 26%, from a baseline of 85 to 107 (p = 0.012). Patients treated with teriparatide for > 12 months (mean 23 months) experienced a mean HU improvement of 25%, from 106 to 132 (p = 0.039). Compared with the mean baseline HU, there was no significant difference after treatment with teriparatide for 3 to 12 months (110 to 119, p = 0.48), denosumab for > 12 months (105 to 107, p = 0.68), or alendronate for > 12 months (111 to 113, p = 0.80).
CONCLUSIONS: Patients treated with romosozumab for a mean of 10.5 months and teriparatide for a mean of 23 months experienced improved spinal bone mineral density as estimated by CT-based opportunistic HU. Given the shorter duration of effective treatment, romosozumab may be the preferred medication for optimization of osteoporotic patients in preparation for elective spine fusion surgery.
摘要：
目的：本研究的目的是确定骨质疏松症药物对基于机会性CT的Hounsfield单位（HU）的影响。
方法：对脊柱和非脊柱手术患者进行回顾性分析，这些患者接受romosozumab治疗3~12个月，特立帕肽3至12个月，特立帕肽治疗>12个月，denosumab持续>12个月,或阿仑膦酸钠治疗>12个月。在L1-4椎体中测量HU。使用单因素方差分析比较5种治疗方案中HU的平均变化。
结果：总计，包括318名患者（70％为女性），平均年龄69岁，平均BMI为27kg/m2。使用romosozumab治疗3至12个月后，平均HU改善（p<0.001）存在显着差异（n=32），特立帕肽3至12个月（n=30），特立帕肽治疗>12个月（n=44），denosumab>12个月（n=123），和阿仑膦酸钠持续>12个月(n=100)。用romosozumab治疗平均10.5个月显著增加平均HU26%，从基线85到107（p=0.012）。使用特立帕肽治疗>12个月（平均23个月）的患者平均HU改善25％，从106到132（p=0.039）。与平均基线HU相比，使用特立帕肽治疗3至12个月后，差异无统计学意义（110至119，p=0.48），denosumab>12个月(105到107，p=0.68)，或阿仑膦酸钠持续>12个月(111至113，p=0.80)。
结论：使用romosozumab治疗平均10.5个月和特立帕肽治疗平均23个月的患者通过基于CT的机会性HU估计，脊柱骨矿物质密度改善。鉴于有效治疗的持续时间较短，romosozumab可能是优化骨质疏松患者的首选药物，为择期脊柱融合手术做准备。
方法：对脊柱和非脊柱手术患者进行回顾性分析，这些患者接受romosozumab治疗3~12个月，特立帕肽3至12个月，特立帕肽治疗>12个月，denosumab持续>12个月,或阿仑膦酸钠治疗>12个月。在L1-4椎体中测量HU。使用单因素方差分析比较5种治疗方案中HU的平均变化。
结果：总计，包括318名患者（70％为女性），平均年龄69岁，平均BMI为27kg/m2。使用romosozumab治疗3至12个月后，平均HU改善（p<0.001）存在显着差异（n=32），特立帕肽3至12个月（n=30），特立帕肽治疗>12个月（n=44），denosumab>12个月（n=123），和阿仑膦酸钠持续>12个月(n=100)。用romosozumab治疗平均10.5个月显著增加平均HU26%，从基线85到107（p=0.012）。使用特立帕肽治疗>12个月（平均23个月）的患者平均HU改善25％，从106到132（p=0.039）。与平均基线HU相比，使用特立帕肽治疗3至12个月后，差异无统计学意义（110至119，p=0.48），denosumab>12个月(105到107，p=0.68)，或阿仑膦酸钠持续>12个月(111至113，p=0.80)。
结论：使用romosozumab治疗平均10.5个月和特立帕肽治疗平均23个月的患者通过基于CT的机会性HU估计，脊柱骨矿物质密度改善。鉴于有效治疗的持续时间较短，romosozumab可能是优化骨质疏松患者的首选药物，为择期脊柱融合手术做准备。
