Effect Of Teripatide And Zoledronic Acid Alone Or In Combination With Vitamin K2 In The Treatment Of Postmenopausal Osteoporosis

Objective:To compare the clinical effect of Teripatide and Zoledronic acid alone or in combination with Vitamin K2 on postmenopausal osteoporosis(PMOP)and their effect on bone metabolism markers.Methods:The retrospective analysis was performed on a total of 140 patients with high-turnover postmenopausal osteoporosis.The patients were chose from the Affiliated Hospital of Qingdao University from November 2018 to November 2020.Among them,Group T: 30 patients received Teripatide(20μg/day,subcutaneously);Group Z: 30 patients received Zoledronic acid(5mg/year,intravenously);Group V: 30 patients received Vitamin K2(15mg tid,orally);Group TV: 23 patients received Teripatide(20μg/day,subcutaneously)in combination with Vitamin K2(15mg tid,orally);Group ZV: 27 patients received Zoledronic acid(5mg/year,intravenously)in combination with Vitamin K2(15mg tid,orally).All of the patients were supplied with adequate Calcium and Vitamin D.The main observation indicators were the bone mineral density(BMD)levels at the lumbar 1-4(L1-4)and the neck of femur after 6 and 12 months of treatment.The secondary observation indicators were the changes of PINP and β-CTX after 3,6 and 12 months of treatment.Subjective medication experience was evaluated by the visual analog scale(VAS).The rate of new and recurrent fractures in patients during treatment;Drug safety and adverse drug reactions.Results:(1)Before treatment,there were no significant differences in age,menopausal duration,body mass index(BMI),BMD of the L1-4 and the femoral neck,the level of β-CTX and PINP,and the VAS scores among the five groups(P > 0.05).(2)After six months of treatment,L1-4 BMD in group TV,group ZV or group T was higher than that in group Z or group V(P<0.05);the BMD of femoral neck in group TV,group ZV,group T or group Z was higher than that in group V(P< 0.05).After 12 months,L1-4 BMD in group TV or group T was higher than that in group ZV,group Z or group V(P < 0.05);the BMD of femoral neck in group TV,group ZV or group Z was higher than that in group T or group V(P<0.05).(3)After 3,6 and 12 months of treatment,the levels of PINP and β-CTX in group TV or group T were significantly higher than those in group ZV,group Z or group V(P<0.05);the levels of PINP and β-CTX in group V were significantly higher than those in group ZV or group Z(P<0.05);The PINP level in group TV was higher than that in group T(P<0.05);the β-CTX level in group ZV was lower than that in group Z(P<0.05).(4)There was no significant difference in the fracture rate before treatment,new fracture rate and re-fracture rate during treatment among the five groups(P>0.05).(5)The VAS scores in all five groups decreased after treatment.In month 3 and 12,the VAS scores from high to low were as follows: group V > group Z > group ZV > group T > group TV(P<0.05).(6)There was no significant difference in the probability of adverse reactions(P>0.05),and no serious adverse events occurred in all five groups.Conclusion:In terms of improving the bone density of lumbar vertebra and relieving the pain,Teripatide is more reliable.The bone density of femoral neck is more sensitive to Zoledronic acid.The combination of vitamin K2 and teripatide had superposition effect on the increase of bone mineral density of femoral neck.The combination of Telipatide or Zoledronic acid and Vitamin K2 don’t increase the risk of adverse reactions.The combination of Teripatide or Zoledronic acid and Vitamin K2 are more effective in the treatment of postmenopausal patients with high turnover osteoporosis.