Postmenopozal osteopeni ve osteoporoz tedavisinde farklı tedavi modalitelerinin etkinliği çalışması

Effectiveness of different treatment modalities in postmenopausal women with osteopenia and osteoporosis

Abstract

OBJECTIVE: The aim of this study was to evaluate the efficacy of different antiresorptive agents and hormone therapy (HT) on T score and to compare their effectiveness with each other. STUDY DESIGN: Medical records of 1073 postmenopausal women were reviewed. Patients were classified into four groups; hormone therapy, antiresorptive therapy (AT), combined HT and AT and control. Groups were evaluated with their response to treatment modality by measuring the changes on T score. Also, patients of HT and AT groups were compared with each other according to the effectiveness of the treatment on T score changes. RESULTS: Treatment related increase in T score was significantly different in HT-AT and AT groups compared with the HT group (P=0.001, P=0.001). Within the HT group (estrogen: 170, estrogen-progestin: 234, tibolone: 136) the alteration on T score was statistically significant compared to the control group (P=0.001, P=0.001, P = 0.001). Within the AT group (etidronate: 165, alendronate: 94, risedronate : 11, calcitonin: 10) all agents were significantly different compared to the control group according to the alterations on T score (P=0.001, P=0.001, P=0.001, P = 0.001). When the change in T score was compared, the alendronate group was significantly different than the etidronate group (P=0.001). CONCLUSION: Hormone therapy combined with AT and AT alone was found to be superior to HT in terms of increments in T score values in postmenopausal women with osteopenia and osteoporosis.

Özet

AMAÇ: Farklı antirezorptif ajanların ve hormon tedavisinin (HT) T skoru üzerine etkisi araştırıldı. GEREÇ VE YÖNTEM: Postmenopozal 1073 hasta çalışmaya dahil edildi. Hastalar aldıkları tedavilere göre HT, antirezorptif, HT ve antirezorptif tedavi kombine ve kontrol grubu olarak dört gruba ayrıldılar. Tedaviye yanıt T skorundaki değişimle değerlendirildi. Ayrıca hormon tedavisi ve antirezorptif tedavi grubunda alt grup analizi yapıldı. BULGULAR: Antirezorptif ve kombine tedavi alan grupta HT grubuna kıyasla anlamlı fark saptandı (P = 0.001, P = 0.001). Hormon tedavisi (östrojen:170, östrojen-progestin: 234, tibolon:136) grubunda kontrol grubuna göre T skorundaki değişim anlamlı idi (P = 0.001, P = 0.001, P = 0.001). Antirezorptif tedavi (etidronat: 165, alendronat: 94, risedronat:11, kalsitonin: 10) alan grupta da kontrol grubuna göre anlamlı değişim saptandı (P = 0.001, P = 0.001, P = 0.001, P = 0.001) . Alt grup analizinde T skorundaki değişim sadece alendronat ve etidronat arasında bulundu (P=0.001). SONUÇ: Postmenopozal osteopeni-osteoporozlu olgularda, hormon tedavisi ve antirezorptif tedavi kombinasyonu tek ajan tedaviye kıyasla T skoru üzerinde daha etkilidir.