骨形成作用を有する骨粗鬆症治療薬テリパラチドの治療成績

Clinical Results of Teriparatide Treatment of Osteoporosis

　目的：骨粗鬆症患者にテリパラチドを12カ月投与した後の治療成績を検討すること．

　対象と方法：対象患者はテリパラチド20μgを連日皮下注射した67例である．投与後12カ月での治療成績を腰椎・大腿骨頚部骨密度と骨代謝マーカー血清Ⅰ型プロコラーゲンN端末プロペプチド(血清P1NP)，尿中Ⅰ型コラーゲン架橋N-テロペプチド(尿中NTX)で検討した．

　結果：12カ月の治療で腰椎骨密度は平均11.4％増加し，大腿骨頚部は平均0.8％増加した．4カ月後の血清P1NPは開始時に比べて平均403％増加し，4カ月後の尿中NTXは平均133％増加していた．

　まとめ：骨粗鬆症に対するテリパラチドの優れた治療効果が認められた．

　Background：Once-daily injections of teriparatide increase bone formation and bone mass.　The aim of this study was to evaluate the efficacy of daily subcutaneous teriparatide administration for 12 months.

　Methods：Sixty-seven osteoporosis patients were enrolled in this study.　The bone mineral density (BMD) of the lumbar spine and femoral neck was measured every four months.　A bone formation marker 〔amino-terminal propeptide of type I procollagen (P1NP)〕 in the patients' serum and a bone resorption marker 〔cross-linked N-telopeptides of type I collagen (NTX)〕 in the patients' urinary were measured at baseline and at one month and four months after the start of treatment.

　Results：Teriparatide treatment significantly increased the BMD of the lumbar spine by 11.4% at 12 months.　The BMD of the femoral neck had increased by 0.8%.　P1NP had increased rapidly at one month, and it remained high until four months.　At four months, teriparatide treatment had significantly increased the average P1NP level by 403% and the average NTX level by 133%.

　Conclusions：Teriparatide effectively increased both lumbar BMD and bone marker levels.