合成代谢疗法增强骨质疏松HRT的疗效

Anabolic treatments enhance the efficacy of hormone replacement therapy (HRT) in postmenopausal women with osteoporosis, findings from the POWER study suggest.

The pharmacological management of postmenopausal osteoporosis has traditionally focused on anti-resorptive agents, such as calcitonin and the bisphosphonates, along with HRT, usually estrogen alone or combined with progestin.

More recently, anabolic therapies, such as the N-terminal fragment of parathyroid hormone (PTH) or the full-length human PTH protein, have been used.

However, little is known about the effects of combining traditional and novel therapies, Ignac Fogelman (Guy's King's and St. Thomas' School of Medicine, London, UK) and fellow members of the Prevention of Osteoporosis in Women on Estrogen Replacement (POWER) study note.

To investigate, the team randomly assigned 180 postmenopausal women currently using HRT to receive injections with PTH 100 µg/day or placebo for 2 years and compared their resulting bone health.

After 18 months of follow-up, the authors found that bone mineral density (BMD) at the lumbar spine had increased by 7.9% in those women given PTH injections compared with an increase of 1.5% in those given placebo injections.

The increase in BMD became significantly different between the two groups of women after only 6 months of treatment.

In addition, over the first 18 months of the study, BMD at the lumbar spine increased in the majority of women given PTH injections (94%) but only around half of those given placebo (59%).

PTH also had significantly greater beneficial effects than placebo on femoral neck BMD and markers of bone turnover, but its effect on total hip BMD or BMD of the distal radius did not reach statistical significance.

Importantly, PTH treatment was generally well tolerated, but, as expected, mild-to-moderate side effects, including hypercalciuria, hypercalcemia, nausea, vomiting, and dizziness, were experienced more frequently in women taking PTH than in women taking placebo.

"The addition of PTH to stable long-term HRT produced a statistically significant increase in lumbar spine BMD relative to HT alone," Fogelman and team conclude.

"The use of PTH in such women may therefore provide an additional approach to osteoporosis risk reduction in women already receiving HT," the investigators conclude in the journalCalcified Tissue International.

来源：http://www.medwire-news.md/437/76482/Bone_Health/Anabolic_treatment_enhances_bone_benefits_of_hormone_therapy_POWER.html

TAG: HRT 骨质疏松 疗法 疗效 合成代谢