地舒单抗治疗后维持骨吸收标志物极低水平1年可预防2年时的骨量丢失：ReoLaus研究
Keeping bone resorption markers very low for 1 year after denosumab prevents bone loss at 2 years: the ReoLaus study.
摘要(中文译文)
停用地舒单抗后骨密度丢失常见，且治疗时间越长，骨密度丢失越严重。血清交联C端肽（sCTX）可预测停药后腰椎骨密度丢失。第一年将sCTX维持在正常上限（ULN）下半区以下，是避免2年时骨密度丢失的必要条件。停用地舒单抗（DD）后，血清交联C端肽（sCTX）升高与2年内骨密度（BMD）丢失相关。双膦酸盐可减少但并非总能防止这种丢失。旨在确定停用地舒单抗后维持骨密度的sCTX阈值。回顾性纳入接受≥2次地舒单抗注射、停药后随访≥2年且定期测量骨密度和sCTX的绝经后女性。采用线性回归分析和ROC曲线确定预防1年和2年腰椎（LS）骨密度丢失的sCTX阈值（%ULN，即绝经前女性正常值上限的百分比）。161名女性共接受8.0±2.9次注射，其中50%在2年后出现骨密度丢失。停药时，未丢失组与丢失组各部位骨密度相似，但丢失组接受的注射次数更多。其T值在1年和2年后下降（p<0.001）。两个时间段内骨密度丢失均与sCTX升高高度相关。停药后，第一年sCTX水平可预测1年和2年腰椎骨密度丢失。第一年避免1年和2年腰椎骨密度丢失的最佳sCTX阈值分别为69%和49% ULN；若要求100%灵敏度，则分别为32%和23% ULN。丢失组接受≥3次唑来膦酸输注的比例更高，而仅接受阿仑膦酸治疗的比例较低。停用地舒单抗后第一年的sCTX水平可预测1年和2年腰椎骨密度丢失。第一年需将sCTX维持在正常上限下半区以下以避免骨密度丢失。尽管使用了高剂量双膦酸盐，仍并非总能达到该目标。
Abstract
BMD loss is common after denosumab discontinuation, and longer treatment is associated with greater BMD loss. Serum crosslaps (sCTX) can predict BMD loss at the lumbar spine after discontinuation. Keeping sCTX below the lower half of the ULN during the first year is needed to avoid BMD loss at 2 years. After denosumab discontinuation (DD), elevated serum crosslaps (sCTX) is associated with bone mineral density (BMD) loss over 2 years. Bisphosphonates reduce but do not always prevent this loss. To define an sCTX threshold below which BMD is maintained after DD. Postmenopausal women receiving ≥ 2 denosumab doses and followed ≥ 2 years after DD with regular BMD and sCTX measurements were included retrospectively. Linear regression analysis and ROC curves were performed to define sCTX threshold (%ULN, upper limit of the norm in premenopausal women) preventing 1- and 2-year lumbar spine (LS) BMD loss. From 161 women who had received 8.0 ± 2.9 injections, 50% lost BMD after 2 years. BMD at DD were similar at all sites in non-losers and losers' groups but losers had received more injections. Their T-score decreased after 1 and 2 years (p < 0.001). BMD loss was highly correlated with increased sCTX during both periods. After DD, first-year sCTX levels predicted 1- and 2-year LS BMD loss. The optimal sCTX thresholds during the first year to avoid LS BMD loss at 1 and 2 years were 69% and 49% ULN; for 100% sensitivity, they were 32% and 23% ULN, respectively. Losers received more often ≥ 3 zoledronate infusions and were less treated with alendronate only. sCTX level during the first year after DD predict 1- and 2-year LS BMD loss. Keeping sCTX below the lower half of the ULN during the first year is needed to avoid BMD loss. Despite high bisphosphonates doses, it is not always possible to reach this target.
如何引用
AMA
Giovanni Liebich, Olivier Lamy, Jérôme Pasquier, Elena Gonzalez-Rodriguez. Keeping bone resorption markers very low for 1 year after denosumab prevents bone loss at 2 years: the ReoLaus study.. Archives of osteoporosis. 2026; doi:10.1007/s11657-026-01747-0.
APA
Giovanni Liebich, Olivier Lamy, Jérôme Pasquier, Elena Gonzalez-Rodriguez (2026). Keeping bone resorption markers very low for 1 year after denosumab prevents bone loss at 2 years: the ReoLaus study.. Archives of osteoporosis. https://doi.org/10.1007/s11657-026-01747-0
GB/T 7714
Giovanni Liebich, Olivier Lamy, Jérôme Pasquier, Elena Gonzalez-Rodriguez. Keeping bone resorption markers very low for 1 year after denosumab prevents bone loss at 2 years: the ReoLaus study.[J]. Archives of osteoporosis, 2026 doi:10.1007/s11657-026-01747-0.
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