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首页> 外文期刊>Journal of bone and mineral metabolism >Analysis of bone metabolism during early stage and clinical benefits of early intervention with alendronate in patients with systemic rheumatic diseases treated with high-dose glucocorticoid: Early DIagnosis and Treatment of OsteopoRosis in Japan (EDITOR-J) study
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Analysis of bone metabolism during early stage and clinical benefits of early intervention with alendronate in patients with systemic rheumatic diseases treated with high-dose glucocorticoid: Early DIagnosis and Treatment of OsteopoRosis in Japan (EDITOR-J) study

机译：大剂量糖皮质激素治疗的系统性风湿病患者早期骨代谢及阿仑膦酸早期干预的临床获益：日本早期诊断和骨质疏松症的治疗（EDITOR-J）研究

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We conducted a prospective multicenter study to assess early changes in the dynamics of bone metabolism in patients with systemic connective tissue diseases following commencement of high-dose glucocorticoid therapy and the benefits of early treatment with bisphosphonate and vitamin D analogue. The subjects of this randomized controlled trial were 106 female patients with systemic connective tissue diseases treated for the first time with glucocorticoids at doses equivalent to prednisolone aeyen20 mg/day (age aeyen 18 years). One week after initiation of glucocorticoid therapy, patients were randomly assigned to treatment with alfacalcidol at 1 mu g/day (n = 33), alendronate 35 mg/week (n = 37), and alfacalcidol plus alendronate (n = 36). The primary endpoints were changes in lumbar spine bone density at 6 months of treatment and the frequency of bone fracture at 12 months. Commencement of glucocorticoid therapy was associated with a rapid and marked bone resorption within 1 week. The combination of alfacalcidol and alendronate administered after the first week of glucocorticoid therapy halted the pathological processes affecting bone metabolism, increased bone density, and reduced the incidence of bone fracture over a period of 12 months. Taken together, the use of the combination of alfacalcidol and alendronate improved bone metabolism, increased bone density, and significantly reduced the incidence of bone fracture during 1-year high-dose glucocorticoid therapy.
机译：我们进行了一项前瞻性多中心研究，以评估开始大剂量糖皮质激素治疗后系统性结缔组织病患者骨代谢动力学的早期变化以及双膦酸盐和维生素D类似物早期治疗的益处。该随机对照试验的受试者为106名女性全身性结缔组织病患者，首次接受糖皮质激素治疗，剂量相当于泼尼松龙aeyen20 mg / day（艾恩年龄18岁）。开始糖皮质激素治疗后一周，患者被随机分配接受阿法骨化醇的治疗，剂量为每天1μg/天（n = 33），阿仑膦酸35 mg /周（n = 37）和阿法骨化醇加阿仑膦酸盐（n = 36）。主要终点是治疗6个月时腰椎骨密度的变化和12个月时骨折的频率。糖皮质激素治疗的开始与1周内骨吸收迅速且明显相关。在糖皮质激素治疗的第一周后联合使用阿法骨化醇和阿仑膦酸盐，可在12个月内中止影响骨代谢的病理过程，增加骨密度，并减少骨折的发生率。总之，在1年大剂量糖皮质激素治疗期间，阿法骨化醇和阿仑膦酸盐的组合可改善骨代谢，增加骨密度并显着降低骨折的发生率。

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