治疗24个月后总髋骨矿物质密度(THBMD)变化与骨折风险降低之间存在很强的相关性。我们研究了治疗12个月和18个月后THBMD的变化是否也与骨折风险降低相关。我们使用了来自22名随机分组的个体患者数据(n=122235名参与者),安慰剂对照,骨质疏松症药物的双盲试验。我们使用每个试验的可用数据计算了12、18和24个月时THBMD(活性安慰剂)的平均百分比变化的差异。我们确定了整个随访期间与治疗相关的骨折复位,使用logistic回归分析放射性椎体骨折,Cox回归分析髋关节,非椎骨,“所有”(非椎骨的组合,临床椎体,和放射学椎骨)骨折,和所有临床骨折(非椎骨和临床椎骨的组合)。我们进行了荟萃回归,以估计每个BMD测量间隔的THBMD变化与骨折风险降低的治疗相关差异之间的研究水平关联(r2和95%置信区间)。荟萃回归显示,对于椎骨骨折,r2(95%置信区间)为0.59(0.19,0.75),0.69(0.32,0.82),12、18和24个月为0.73(0.33、0.84),分别。对于髋部观察到类似的模式:r2=0.27(0.00,0.54),0.39(0.02,0.63),和0.41(0.02,0.65);非椎体:r2=0.27(0.01,0.52),0.49(0.10,0.69),和0.53(0.11,0.72);所有骨折:r2=0.44(0.10,0.64),0.63(0.24,0.77),和0.66(0.25,0.80);所有临床骨折:r2=0.46(0.11,0.65),0.64(0.26,0.78),和0.71(0.32,0.83),对于12-,THBMD的18个月和24个月变化,分别。这些研究结果表明,治疗相关的THBMD在12、18和24个月的变化与骨折风险的降低有关。我们得出结论,短至12个月的BMD测量间隔可用于评估骨折疗效。但随着BMD测量间隔的延长,这种关联更强。
在这项研究中,我们研究了髋骨密度随时间的变化与服用骨质疏松药物的患者发生骨折的风险之间的关系.我们分析了来自22个不同临床试验的122,000多名参与者的数据。我们发现,治疗12、18和24个月后测量的骨密度增加与骨折风险有关。具体来说,骨密度的改善与脊柱骨折的减少有关,臀部,和其他骨头。使用统计方法,我们计算了这种联系的强度。我们发现,后来我们测量了服用药物的人的骨矿物质密度,骨密度提高和骨折风险降低之间的联系越强.我们的发现表明,治疗12个月后的骨密度测量可以帮助预测药物预防骨折的效果。然而,最好的预测来自较长时间内测量的骨密度变化。
There is a strong association between total hip bone mineral density (THBMD) changes after 24 months of treatment and reduced fracture risk. We examined whether changes in THBMD after 12- and 18 months of treatment are also associated with fracture risk reduction. We used individual patient data (n = 122 235 participants) from 22 randomised, placebo-controlled, double-blind trials of osteoporosis medications. We calculated the difference in mean percent change in THBMD (active-placebo) at 12, 18, and 24 months using data available for each trial. We determined the treatment-related fracture reductions for the entire follow-up period, using logistic regression for radiologic vertebral fractures and Cox regression for hip, non-vertebral, \"all\" (combination of non-vertebral, clinical vertebral, and radiologic vertebral) fractures, and all clinical fractures (combination of non-vertebral and clinical vertebral). We performed meta-regression to estimate the study-level association (r2 and 95% confidence interval) between treatment-related differences in THBMD changes for each BMD measurement interval and fracture risk reduction. The meta-regression revealed that for vertebral fractures, the r2 (95% confidence interval) was 0.59 (0.19, 0.75), 0.69 (0.32, 0.82), and 0.73 (0.33, 0.84) for 12, 18 and 24 months, respectively. Similar patterns were observed for hip: r2 = 0.27 (0.00, 0.54), 0.39 (0.02, 0.63), and 0.41 (0.02, 0.65); non-vertebral: r2 = 0.27 (0.01, 0.52), 0.49 (0.10, 0.69), and 0.53 (0.11, 0.72); all fractures: r2 = 0.44 (0.10, 0.64), 0.63 (0.24, 0.77), and 0.66 (0.25, 0.80); and all clinical fractures: r2 = 0.46 (0.11, 0.65), 0.64 (0.26, 0.78), and 0.71 (0.32, 0.83), for 12-, 18- and 24-month changes in THBMD, respectively. These findings demonstrate that treatment-related THBMD changes at 12, 18 and 24 months are associated with fracture risk reductions across trials. We conclude that BMD measurement intervals as short as 12 months could be used to assess fracture efficacy, but the association is stronger with longer BMD measurement intervals.
In this study, we looked at how changes in hip bone density over time relate to the risk of fractures in people taking osteoporosis medications. We analysed data from over 122 000 participants across 22 different clinical trials. We found that the increase in bone density measured after 12, 18, and 24 months of treatment was linked to the risk of fractures. Specifically, greater improvements in bone density were associated with fewer fractures in the spine, hips, and other bones. Using statistical methods, we calculated the strength of this association. We discovered that the later we measured bone mineral density in people taking the medication, the stronger the link between improved bone density and reduced fracture risk became. Our findings suggest that bone density measurements after 12 months of treatment could help predict how well a medication will prevent fractures. However, the best predictions came from bone density changes measured over longer periods.