| Objective Two different mechanisms of anti-osteoporosis drugs were used in the treatment of postmenopausal osteoporosis for the first time,when the most common adverse reactions occurs,the risk factors were analyzed,and also to explore whether there was a relationship between the occurrence of adverse reactions with different bone transformation state and vitamin D levels.Thus,to offer help for the clinical prevention and treatment of adverse reactions as well as how to choose anti-osteoporosis drugs.Methods Choose patients in our hospital(General Hospital of Ningxia Medical University)from January 2017 to June 2020,with the diagnosis of osteoporosis in postmenopausal women.A total of 381 cases,age section(45-90 years),according to the telephone follow-up results and the first use of anti-osteoporosis drugs,the research object were divided into the group of zoledronic acid(307 cases)and the group of teripartide(74cases).Then,those subjects in the two groups were divided into the group with adverse reactions and the group without adverse reactions according to the occurrence of adverse reactions,and the next,grouped respectively on the basis of vitamin D level and P1 NP level,and use statistical software to analyze whether these two risk factors are related to the occurrence of adverse reactions.The incidence of adverse reactions was not compared between the zoledronic acid group and the teripartide group.Results 1.Among the 307 patients(age: 63.03 ± 9.34 years of age)who were first treated with zoledronic acid for osteoporosis,there were 99 cases developed acute phase response(APR),accounting for 32.2% of the total subjects.In all subjects,there were 56.7% of the subjects with a level of 25(OH)D below 20 ng/m L and were considered vitamin D deficiency;The level of 25(OH)D in patients with acute adverse reactions(APR+)was16.75±9.20ng/ml,which was significantly lower than the patients without APR(APR-)(23.68±10.67ng/ml).The serum P1 NP level in APR+ patients was 73.95 ±34.50ng/ml,significantly higher than that in APR-patients: 55.80±36.91ng/ml.Both lower vitamin D and higher P1 NP levels were the risk factors for acute adverse reactions(APR)after the first infusion of zoledronic acid.2.Among the 74 patients(age: 67.14 ± 9.21 years of age)treated with teripartide for osteoporosis,14 cases developed musculoskeletal symptoms,representing 18.9% of the total.There were 59.5% of the subjects with a level of 25(OH)D below 20 ng/m L and were considered vitamin D deficiency.The level of 25(OH)D in patients with musculoskeletal symptoms was 15.96±8.17ng/ml,the level of 25(OH)D in the subjects without musculoskeletal symptoms was 20.86±8.52ng/ml,there was no statistical significance between both,as for the reason,consideration is related to insufficient sample size.The P1 NP level of the subjects with musculoskeletal symptoms was96.85 ± 58.52ng/ml,significantly higher than that of the subjects without musculoskeletal symptoms55.28 ± 27.87ng/ml.Excessive levels of P1 NP,it also means overactive osteogenesis,is a risk factor for musculoskeletal adverse reactions to teripartide administration.Conclusion 1.The serum 25(OH)D level in the body was negatively correlated with the incidence of acute adverse reactions after the first infusion of zoledronic acid in postmenopausal osteoporosis.That is,the lower the level of 25(OH)D,the higher the incidence of acute adverse reactions;2.When the rate of bone formation is increased and osteoblast cells are active,the risk of adverse reactions in the acute phase is increased with the use of zoledronic acid as a anti-osteoporosis therapy on postmenopausal osteoporosis;3.There was no significant correlation between 25(OH)D levels and musculoskeletal symptoms induced by terapatide treatment for postmenopausal osteoporosis.4.When the rate of bone formation increases and osteoblast cells are active,the risk of adverse reactions to musculoskeletal symptoms increases with the use of teripartide to anti-osteoporosis therapy in postmenopausal osteoporosis. |
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