オカダ ヨウスケ   Okada Yosuke
  岡田 洋右
   所属   医学部医学科  臨床医学系 第1内科学
   職種   准教授
論文種別 原著
言語種別 英語
査読の有無 査読あり
表題 Analysis of bone metabolism during early stage and clinical benefits of early intervention with alendronate in patients with systemic rheumatic diseases treated with high-dose glucocorticoid: Early DIagnosis and Treatment of OsteopoRosis in Japan (EDITOR-J) study.
掲載誌名 正式名:Journal of bone and mineral metabolism
略  称:J Bone Miner Metab
ISSNコード:14355604/09148779
掲載区分国外
巻・号・頁 34(6),646-654頁
著者・共著者 Tanaka Yoshiya, Mori Hiroko, Aoki Takatoshi, Atsumi Tatsuya, Kawahito Yutaka, Nakayama Hisanori, Tohma Shigeto, Yamanishi Yuji, Hasegawa Hitoshi, Tanimura Kazuhide, Negoro Nobuo, Ueki Yukitaka, Kawakami Atsushi, Eguchi Katsumi, Saito Kazuyoshi, Okada Yosuke
発行年月 2016/11
概要 We conducted a prospective multicenter study to assess early changes in the dynamics of bone metabolism in patients with systemic connective tissue diseases following commencement of high-dose glucocorticoid therapy and the benefits of early treatment with bisphosphonate and vitamin D analogue. The subjects of this randomized controlled trial were 106 female patients with systemic connective tissue diseases treated for the first time with glucocorticoids at doses equivalent to prednisolone ≥20 mg/day (age ≥ 18 years). One week after initiation of glucocorticoid therapy, patients were randomly assigned to treatment with alfacalcidol at 1 μg/day (n = 33), alendronate 35 mg/week (n = 37), and alfacalcidol plus alendronate (n = 36). The primary endpoints were changes in lumbar spine bone density at 6 months of treatment and the frequency of bone fracture at 12 months. Commencement of glucocorticoid therapy was associated with a rapid and marked bone resorption within 1 week. The combination of alfacalcidol and alendronate administered after the first week of glucocorticoid therapy halted the pathological processes affecting bone metabolism, increased bone density, and reduced the incidence of bone fracture over a period of 12 months. Taken together, the use of the combination of alfacalcidol and alendronate improved bone metabolism, increased bone density, and significantly reduced the incidence of bone fracture during 1-year high-dose glucocorticoid therapy.
DOI 10.1007/s00774-015-0709-8
PMID 26308708