Abstract：
BACKGROUND: Bisphosphonates and denosumab increase bone mineral density (BMD) for osteoporosis treatment in patients with aromatase inhibitor-associated bone loss (AIBL). This study aimed to directly compare bisphosphonates with denosumab in treating patients with AIBL and to determine the effect of denosumab on the trabecular bone score (TBS).
METHODS: Thirty-nine patients with AIBL receiving osteoporosis treatment (21 in the bisphosphonates group and 18 in the denosumab group) were retrospectively evaluated for changes in lumbar spine and femoral BMD, lumbar spine bone quality (assessed by TBS), and blood bone metabolic markers. The Mann-Whitney and Wilcoxon tests were used for statistical evaluation.
RESULTS: After 24 months of treatment, the lumbar spine BMD change rate was 5.82 ± 1.10% with bisphosphonates and 10.49 ± 1.20% with denosumab, with the change rate of denosumab significantly increasing over that of bisphosphonates. The change rate in femoral BMD was 2.69 ± 1.16% with bisphosphonates and 2.95 ± 1.26% with denosumab, with no significant difference between the two groups. The rate of decrease in tartrate-resistant acid phosphatase isoform 5b was significantly higher in the denosumab group. The change rate in TBS at 24 months of treatment was 0.53 ± 1.26% in the bisphosphonates group and 1.08 ± 1.33% in the denosumab group, with no significant difference between the two groups. After 24 months, TBS remained stable.
CONCLUSIONS: Both bisphosphonates and denosumab may increase BMD, improve bone metabolism, and inhibit bone quality loss in patients with AIBL.
METHODS: Thirty-nine patients with AIBL receiving osteoporosis treatment (21 in the bisphosphonates group and 18 in the denosumab group) were retrospectively evaluated for changes in lumbar spine and femoral BMD, lumbar spine bone quality (assessed by TBS), and blood bone metabolic markers. The Mann-Whitney and Wilcoxon tests were used for statistical evaluation.
RESULTS: After 24 months of treatment, the lumbar spine BMD change rate was 5.82 ± 1.10% with bisphosphonates and 10.49 ± 1.20% with denosumab, with the change rate of denosumab significantly increasing over that of bisphosphonates. The change rate in femoral BMD was 2.69 ± 1.16% with bisphosphonates and 2.95 ± 1.26% with denosumab, with no significant difference between the two groups. The rate of decrease in tartrate-resistant acid phosphatase isoform 5b was significantly higher in the denosumab group. The change rate in TBS at 24 months of treatment was 0.53 ± 1.26% in the bisphosphonates group and 1.08 ± 1.33% in the denosumab group, with no significant difference between the two groups. After 24 months, TBS remained stable.
CONCLUSIONS: Both bisphosphonates and denosumab may increase BMD, improve bone metabolism, and inhibit bone quality loss in patients with AIBL.
摘要：
背景：双膦酸盐和地诺单抗可增加芳香化酶抑制剂相关骨丢失（AIBL）患者骨质疏松治疗的骨密度（BMD）。这项研究旨在直接比较双膦酸盐和denosumab治疗AIBL患者的疗效，并确定denosumab对小梁骨评分（TBS）的影响。
方法：回顾性评估了39例接受骨质疏松症治疗的AIBL患者（双膦酸盐组21例，地诺单抗组18例）的腰椎和股骨BMD变化，腰椎骨质量（通过TBS评估），和血骨代谢标志物。Mann-Whitney和Wilcoxon检验用于统计评价。
结果：治疗24个月后，双膦酸盐的腰椎BMD变化率为5.82±1.10％，denosumab的为10.49±1.20％，与双膦酸盐相比，地诺单抗的变化率显着增加。双膦酸盐的股骨BMD变化率为2.69±1.16％，地诺塞马的为2.95±1.26％，两组间无显著性差异。denosumab组的抗酒石酸酸性磷酸酶同工型5b的下降率明显更高。治疗24个月时TBS的变化率双膦酸盐组为0.53±1.26%,地诺单抗组为1.08±1.33%,两组间无显著性差异。24个月后,TBS保持稳定。
结论：双膦酸盐和地诺单抗都可能增加骨密度，改善骨代谢，并抑制AIBL患者的骨质量损失。
方法：回顾性评估了39例接受骨质疏松症治疗的AIBL患者（双膦酸盐组21例，地诺单抗组18例）的腰椎和股骨BMD变化，腰椎骨质量（通过TBS评估），和血骨代谢标志物。Mann-Whitney和Wilcoxon检验用于统计评价。
结果：治疗24个月后，双膦酸盐的腰椎BMD变化率为5.82±1.10％，denosumab的为10.49±1.20％，与双膦酸盐相比，地诺单抗的变化率显着增加。双膦酸盐的股骨BMD变化率为2.69±1.16％，地诺塞马的为2.95±1.26％，两组间无显著性差异。denosumab组的抗酒石酸酸性磷酸酶同工型5b的下降率明显更高。治疗24个月时TBS的变化率双膦酸盐组为0.53±1.26%,地诺单抗组为1.08±1.33%,两组间无显著性差异。24个月后,TBS保持稳定。
结论：双膦酸盐和地诺单抗都可能增加骨密度，改善骨代谢，并抑制AIBL患者的骨质量损失。
