Wirksamkeit von Etidronat und sequenziellem Monofluorphosphat bei schwerer postmenopausaler Osteoporose

Zusammenfassung

Innerhalb einer dreijährigen Pilotstudie an 52 Frauen mit schwerer postmenopausaler Osteoporose wurden die Behandlungen mit Etidronat und anschließender Gabe von Kalzium und Vitamin D (ECaD) einerseits bzw. mit Etidronat und anschließender Verabreichung von Monofluorphosphat plus Kalzium und Vitamin D (EFCaD) andererseits miteinander verglichen. Die Knochenmineraldichte (BMD) von Lendenwirbelsäule, Gesamthüfte und Schenkelhals nahm mit dem EFCaD-Regime signifikant stärker zu als mit dem ECaD-Regime. Der Score für Schmerzen/Mobilität ging mit EFCaD signifikant stärker zurück als mit ECaD (p=0,006).Neue vertebrale Frakturen traten beidrei Patientinnen unter EFCaD (12%) bzw. neun Patientinnen unter ECaD (35%) auf (p = 0,048). Bei drei Patientinnen unter EFCaD (12%) bzw. 15 Patientinnen unter ECaD (58%) war kein Ansprechen (Response) auf die Therapie zu verzeichnen (p-Wert des Unterschieds = 0,001). Bei 25 Patientinnen wurde über leichte bis mittelschwere unerwünschte Ereignisse berichtet, wobei zwischen den beiden Behandlungsgruppen keine signifikanten Unterschiede zu beobachten waren. Die Pilotstudie deutet darauf hin, dass Etidronat, sequenziell gefolgt von Monofluorphosphat, eine sichere, wirksame und relativ kostengünstige Therapie bei schwerer postmenopausaler Osteoporose darstellen könnte.

Summary

In a three-year pilot study on 52 women with severe postmenopausal osteoporosis, treatment with etidronate followed by calcium and vitamin D (ECaD) was compared to etidronate followed by monofluorophosphate, calcium and vitamin D (EFCaD). BMD in lumbar spine, total hip and femoral neck increased significantly more with EFCaD than with ECaD. Pain-mobility score decreased significantly more with EFCaD than with EcaD (p = 0.006). New vertebral fractures occurred in three patients under EFCaD (12%) and in nine under EcaD (35%), (p=0.048).Three patients under EFCaD (12%) and 15 under EcaD (58%) did not respond to therapy (p of difference = 0.001). Mild or moderate adverse reactions were reported by 25 patients, with no significant difference between the two groups. The pilot study suggests that etidronate, sequentially followed by monofluorophosphate, could be a safe, effective and relatively inexpensive therapy in severe postmenopausal osteoporosis.

Englische Originalarbeit[*] erschienen in: Rheumatol Int 2005; 25: 296–300

Schlüsselwörter

Postmenopausale Osteoporose - Etidronat - Monofluorphosphat

Keywords

Postmenopausal osteoporosis - etidronate - monofluorophosphate

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