期刊
BONE
卷 120, 期 -, 页码 44-49出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.bone.2018.10.001
关键词
Denosumab; Zoledronic acid; Teriparatide; Bone remodeling; Wnt-inhibitors; Myostatin
资金
- MedDrive Starting Grant
- Frauenhabilitationsstipendium of Technische Universitat Dresden
- DFG SPP muBONE
Purpose: Prior osteoporosis therapies may affect the skeletal response to denosumab. We compared the effect of denosumab (60 mg every 6 months for 12 months) on bone mineral density and bone metabolism parameters in postmenopausal women with low bone mass who were either treatment-naive (n = 30), or previously treated either with zoledronic acid (n = 30), or teriparatide (n = 22). Methods: We assessed lumbar spine bone mineral density (BMD) and measured serum concentrations of the bone turnover markers pro-collagen type 1 N-terminal propeptide (PINP) and C-terminal-cross-linking telopeptide of type 1 collagen (CTX), as well as sclerostin, dickkopf-1 (Dkk-1), and myostatin. Results: Lumbar spine BMD increased equivalently in all three groups after 12 months of denosumab compared to baseline (p < 0.001). Serum PINP and CTX decreased significantly with denosumab in pre-treated women reaching the same nadir levels as in treatment-naive patients (p < 0.001). Women pre-treated with teriparatide displayed lower baseline myostatin concentrations as compared to the other two groups (p < 0.001). Changes in lumbar spine BMD in teriparatide pre-treated women correlated with changes in bone turnover markers and myostatin. Conclusions: Denosumab induced similar increases in lumbar spine BMD in treatment-naive and pre-treated patients and suppressed serum PINP and CTX to the same levels regardless of prior treatments. In teriparatide pre-treated patients the magnitude of change in bone turnover markers is associated with BMD response.
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