JCEM:特立帕肽治疗WNT1或PLS3突变相关的骨质疏松症

2016-10-17 MedSci MedSci原创

在之前的研究中,我们识别了两个显性遗传的芬兰家庭中,WNT1或PLS3突变是低转换型骨质疏松的病因。 本项前瞻性、纵向的、不受控制的研究,其目的是评估这些突变患者对特立帕肽治疗的反应。 研究纳入了六名成人(平均年龄54岁)患者,3例有WNT1基因错义突变c.652T>G,3例有PLS3基因剪接突变c.73-24T>A,接受特立帕肽 20 μg/天,治疗24个月。五例患者曾接

在之前的研究中,我们识别了两个显性遗传的芬兰家庭中,WNT1或PLS3突变是低转换型骨质疏松的病因。

本项前瞻性、纵向的、不受控制的研究,其目的是评估这些突变患者对特立帕肽治疗的反应。

研究纳入了六名成人(平均年龄54岁)患者,3例有WNT1基因错义突变c.652T>G,3例有PLS3基因剪接突变c.73-24T>A,接受特立帕肽 20 μg/天,治疗24个月。五例患者曾接受双膦酸盐类药物治疗。

在基线、治疗12个月和24个月时,使用DXA测量腰椎和髋部骨密度(BMD)、以及桡骨远端周边QCT和脊髓造影。在基线、治疗3个月、6个月、12个月和24个月,测量血清骨转换标记物。在基线和治疗24个月时进行配对的双标记髂嵴活检。

数据显示,在治疗前3个月到6个月,所有患者的形成指标P1NP(90-398 %)和和骨钙素(50-280 %)增加,吸收标志物CTX(58-457 %)和Tracp5b (20-68%)也增加。治疗24个月时,5例患者的腰椎骨密度从5.2%增加到7.9%,4例患者的股骨颈骨密度从2.6%增加到7.8%。桡骨远端骨皮质体积骨密度下降了5.4%到26.1%。组织形态学分析显示,WNT1突变患者 vs. PLS3突变患者,骨指数增高高度一致。所有患者的侵蚀表面减少44%至100%。5例患者的脂肪细胞数增加。

结果表明,WNT1或PLS3突变相关的骨质疏松症患者,对特立帕肽治疗有反应。

原始出处:

Välimäki VV.et al.Teriparatide Treatment in Patients with WNT1 or PLS3 Mutation-Related Early-Onset Osteoporosis - A Pilot Study.J Clin Endocrinol Metab. 2016 Oct 12:jc20162423. [Epub ahead of print]

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    2016-12-23 achengzhao
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    2017-10-02 smallant2015
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    2017-03-01 lfcmxl
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    2016-10-20 1e1487afm65(暂无匿称)

    特立帕肽新药

    0

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    2016-10-19 Eleven17
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    2016-10-19 zhwj

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