Yaşlı yetişkinlerde osteoporoz tedavisinde antirezorptif ajanların karşılaştırılması

Year 2022, Volume: 47 Issue: 3, 1248 - 1255, 30.09.2022

Eyyüp Murat Efendioğlu Ahmet Çiğiloğlu Sencer Ganidağlı Zeynel Abidin Öztürk

https://doi.org/10.17826/cumj.1134584

Abstract

Amaç: Yaşlı popülasyonda anti-osteoporotik ilaçların etkinliğini karşılaştıran az sayıda çalışma bulunmaktadır. Bu çalışmada yaşlı yetişkinlerde alendronat, zoledronik asit ve denosumabın etkinliğini karşılaştırmayı amaçladık.
Gereç ve Yöntem: Bu retrospektif çalışmaya 65 yaş ve üzeri osteoporozlu toplam 350 yaşlı dahil edildi. Alendronat, zoledronik asit ve denosumab alan hasta sayısı sırasıyla 111, 121 ve 118 idi. Kemik mineral yoğunluğu (KMY) başlangıçta ve 24. ayda çift enerjili x-ışını absorpsiyometri (DXA) taramaları yapılarak ölçüldü.
Bulgular: Hastaların yaşı, komorbiditeleri ve laboratuvar analiz sonuçları benzerdi. Tedavi grupları arasında femur boynunda KMY yanıtında istatistiksel olarak anlamlı bir fark bulunmazken (alendronat, zoledronik asit ve denosumab için başlangıç KMY'leri sırasıyla 0,61, 0,59 ve 0,58 iken 24. ay KMY'leri sırasıyla 0,62, 0,60 ve 0,59 idi), alendronat ve zoledronik asitin lomber omurga KMY'sini denosumab'dan daha fazla iyileştirdiğini bulduk (alendronat, zoledronik asit ve denosumab için başlangıç KMY'leri sırasıyla 0,74, 0,74 ve 0,71 iken, 24. ay KMY'leri sırasıyla 0,77, 0,78 ve 0,73 idi).
Sonuç: Bu çalışma, parenteral antirezorptif ajanlar gibi, alendronatın da yaşlı osteoporotik yetişkinlerde istenilen KMY yanıtını ortaya çıkarabildiğini göstermiştir. Çalışmamızın sonuçları yaşlı bireylerde osteoporoz tedavisine rehberlik edebilir.

Keywords

Yaşlı yetişkinler, osteoporoz, alendronat, zoledronik asit, denosumab

Comparison of antiresorptive agents in the treatment of osteoporosis in older adults

Abstract

Purpose: There are few studies comparing the effectiveness of anti-osteoporotic drugs among elderly population. In this study, we aimed to compare the effectiveness of alendronate, zoledronic acid, and denosumab in older adults.
Materials and Methods: A total of 350 older adults with osteoporosis, aged 65 and over were included in this retrospective study. The number of patients receiving alendronate, zoledronic acid, and denosumab was 111, 121, and 118, respectively. Bone mineral density (BMD) was measured at baseline and 24th month by performing dual-energy x-ray absorptiometry (DXA) scans.
Results: The age, comorbidities, and laboratory analysis results of the patients were similar. While there was no statistically significant difference in BMD response at the femoral neck between the treatment groups (Baseline BMDs for alendronate, zoledronic acid, and denosumab were 0.61, 0.59, and 0.58, respectively, while 24th month BMDs were 0.62, 0.60, and 0.59, respectively), alendronate and zoledronic acid improved lumbar spine BMD more than denosumab (Baseline BMDs for alendronate, zoledronic acid, and denosumab were 0.74, 0.74, and 0.71, respectively, while 24th month BMDs were 0.77, 0.78, and 0.73).
Conclusion: This study has shown that, like parenteral antiresorptive agents, alendronate can elicit a desirable BMD response in older osteoporotic adults. The results of our study may guide osteoporosis treatment in older individuals.

Keywords

Older adults, osteoporosis, alendronate, zoledronic acid, denosumab

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