臨床整形外科49巻5号

2014年05月発行

臨床経験

原発性骨粗鬆症患者における長期ビスホスホネート治療一時休止後のエルデカルシトール投与の効果

著者： 金谷幸一¹² 島本周治² 青木千春² 児玉泰輝³ 加藤義治²

所属機関： ¹蓮田病院整形外科 ²東京女子医科大学医学部整形外科 ³大原クリニック

ページ範囲：P.455 - P.461

　背景：歯科治療を要するビスホスホネート(BP)内服患者が，中止か継続かで困惑し代替薬が望まれている．本研究はBPからエルデカルシトール(ELD)切り替え時の影響を検討した．

　対象・方法：対象は3年以上BPを内服した17例である．切り替え6カ後の骨密度：腰椎と大腿骨total(H-BMD)，骨代謝マーカー：TRACP-5b，P1NP，TRACP-5b/P1NPの変化を検討した．

　結果：有意な変化は，TRAP-5b/P1NPの低下のみだった．骨密度は維持され，骨代謝回転は骨形成が上昇した．しかし，H-BMD YAM＜70%の症例では，骨密度が大きく減少していた．

　まとめ：H-BMD YAM70%未満を除外すれば，ELDは，短期のBP代替薬となる可能性がある．

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