...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Journal of bone and mineral research: the official journal of the American Society for Bone and Mineral Research >Effect of an aromatase inhibitor on bmd and bone turnover markers: 2-year results of the Anastrozole, Tamoxifen, Alone or in Combination (ATAC) trial (18233230).
【24h】

Effect of an aromatase inhibitor on bmd and bone turnover markers: 2-year results of the Anastrozole, Tamoxifen, Alone or in Combination (ATAC) trial (18233230).

机译：芳香酶抑制剂对bmd和骨转换指标的影响：阿那曲唑，他莫昔芬，单独或联合试验（ATAC）的2年研究结果（18233230）。

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Aromatase inhibitors reduce estrogen levels in postmenopausal women with breast cancer. Residual estrogen is an important determinant of bone turnover. Adjuvant anastrozole was associated with significant BMD loss and increased bone remodeling, whereas tamoxifen reduced bone marker levels. INTRODUCTION: In the Anastrozole, Tamoxifen, Alone or in Combination (ATAC) trial after a median follow-up of 68 months, a significant improvement in disease-free survival was observed with anastrozole treatment (hazard ratio [HR], 0.87; 95% CI, 0.78-0.97; p = 0.01). Anastrozole was also associated with tolerability benefits compared with tamoxifen, but with higher fracture rates. The HR of anastrozole compared with tamoxifen after 60 months of treatment was 1.49 (95% CI, 1.25-1.77). MATERIALS AND METHODS: This prospectively designed subprotocol (n = 308) of ATAC assessed changes in BMD and bone turnover markers in postmenopausal women with invasive primary breast cancer receiving anastrozole 1 mg/day, tamoxifen 20 mg/day, or combination treatment with both agents for 5 years. Patients with osteoporosis were excluded (osteopenia permitted at the investigators discretion). Lumbar spine and total hip BMD was assessed at baseline and after 1 and 2 years; bone turnover markers (serum C-telopeptide, urinary N-telopeptide [NTX], free deoxypyridinoline, serum procollagen type-1 N-propeptide, bone alkaline phosphatase [ALP]) were assessed at baseline and after 3, 6, and 12 months. Results were expressed as median percentage change. RESULTS: After 2 years of anastrozole treatment, BMD was lost at lumbar spine (median 4.1% loss) and total hip (median 3.9% loss) sites; increases of 2.2% and 1.2%, respectively, were observed with tamoxifen. After 1 year of anastrozole treatment, increased bone remodeling was observed (NTX, +15%; 95% CI, 3-25%; bone ALP, +20%; 95% CI, 14-25%); decreased bone remodeling was observed with tamoxifen (NTX, -52%; 95% CI, -62% to -33%; bone ALP, -16%; 95% CI, -24% to -11%). CONCLUSIONS: Anastrozole is associated with significant BMD loss and a small increase in bone turnover, whereas tamoxifen (and the combination) is associated with increased BMD and decreased remodeling. These data may explain the increased fracture risk observed with anastrozole treatment in the ATAC trial. The impact of anastrozole on bone should be weighed against its overall superior efficacy and tolerability as observed in the main ATAC trial.
机译：芳香酶抑制剂可降低绝经后乳腺癌患者的雌激素水平。残余雌激素是骨转换的重要决定因素。佐剂阿那曲唑与明显的骨密度降低和骨重塑增加有关，而他莫昔芬降低骨标志物水平。简介：在中位随访68个月后的阿那曲唑，他莫昔芬，单独或联合试验（ATAC）中，阿那曲唑治疗的无病生存率显着提高（危险比[HR]为0.87; 95％ CI，0.78-0.97; p ＝ 0.01）。与他莫昔芬相比，阿那曲唑也具有耐受性，但骨折率更高。治疗60个月后，阿那曲唑和他莫昔芬的HR为1.49（95％CI，1.25-1.77）。材料和方法：这项前瞻性设计的ATAC子协议（n = 308）评估了接受阿那曲唑1 mg /天，他莫昔芬20 mg /天或两种药物联合治疗的绝经后原发性乳腺癌绝经后妇女BMD和骨转换指标的变化有5年了。排除患有骨质疏松症的患者（研究者酌情允许骨质减少）。在基线以及1年和2年后评估腰椎和全髋骨BMD;在基线以及3、6、12个月后，评估骨转换指标（血清C-端肽，尿N-端肽[NTX]，游离脱氧吡啶并啉，血清胶原蛋白1型N-肽，骨碱性磷酸酶[ALP]）。结果表示为中值百分比变化。结果：经阿那曲唑治疗2年后，腰椎（中位丢失4.1％）和整个髋部（中位丢失3.9％）BMD丢失。他莫昔芬分别增加2.2％和1.2％。阿那曲唑治疗1年后，观察到骨重塑增加（NTX，+ 15％; 95％CI，3-25％;骨ALP，+ 20％; 95％CI，14-25％）;他莫昔芬可降低骨重塑（NTX，-52％; 95％CI，-62％至-33％;骨ALP，-16％; 95％CI，-24％至-11％）。结论：阿那曲唑与明显的BMD损失和骨代谢的少量增加有关，而他莫昔芬（及其组合）与BMD增加和重塑减少有关。这些数据可以解释在ATAC试验中使用阿那曲唑治疗观察到的骨折风险增加。如在主要的ATAC试验中所观察到的，应权衡阿那曲唑对骨骼的影响及其总体优越的功效和耐受性。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号