目的系统评价romosozumab治疗绝经后骨质疏松的有效性及安全性。方法检索中国知网、万方、维普数据库以及PubMed、Embase、Web of Science和Cochrane Library数据库,搜集有关romosozumab治疗绝经后骨质疏松的随机对照试验(RCT),对照措...目的系统评价romosozumab治疗绝经后骨质疏松的有效性及安全性。方法检索中国知网、万方、维普数据库以及PubMed、Embase、Web of Science和Cochrane Library数据库,搜集有关romosozumab治疗绝经后骨质疏松的随机对照试验(RCT),对照措施为安慰剂或其他抗骨质疏松药物。检索时间均为建库至2021年5月1日,使用Cochrane手册推荐的评估工具进行偏倚风险评估及质量评价。采用Review Manager 5.3软件进行Meta分析。结果纳入5项RCT研究,研究对象共12028例,Meta分析结果显示,干预6个月和12个月后,romosozumab组相比于基线的腰椎骨密度百分比变化显著高于对照组(分别为MD=8.59,95%CI:4.39~12.79,P<0.0001;MD=10.53,95%CI:6.72~14.34,P<0.0001)。干预12个月后,romosozumab组股骨颈和全髋骨密度百分比变化也显著高于对照组(均为P<0.0001)。romosozumab组与对照组相比不良事件发生风险显著降低(RR=0.97,95%CI:0.95~0.99,P=0.01),2组严重不良事件发生风险无显著差异(P=0.89)。结论相比于安慰剂或对照药物,romosozumab升高骨密度效果显著,且总体安全性更高,但结论仍需进一步的证实。展开更多
硬骨素(Sclerostin)是由硬化性骨病(sclerosteosis,SOST)基因编码的蛋白质,可以通过与低密度脂蛋白受体相关蛋白5/6(low density lipoprotein receptor-related protein,LRP5/6)结合达到拮抗Wnt蛋白并抑制成骨的作用,已经作为新的药物...硬骨素(Sclerostin)是由硬化性骨病(sclerosteosis,SOST)基因编码的蛋白质,可以通过与低密度脂蛋白受体相关蛋白5/6(low density lipoprotein receptor-related protein,LRP5/6)结合达到拮抗Wnt蛋白并抑制成骨的作用,已经作为新的药物靶点用于抗骨质疏松药物研发。目前,围绕Sclerostin单克隆抗体已经进行了许多基础研究和临床研究,结果提示该类药物可以提高骨量、促进骨形成、抑制骨吸收,对于骨质疏松有一定治疗效果。但该类药物应用后的副反应,对骨折的影响等方面的研究数据尚不足,有待完善进一步研究。展开更多
Promoting bone healing after a fracture has been a frequent subject of research.Recently,sclerostin antibody(Scl-Ab)has been introduced as a new anabolic agent for the treatment of osteoporosis.Scl-Ab activates the ca...Promoting bone healing after a fracture has been a frequent subject of research.Recently,sclerostin antibody(Scl-Ab)has been introduced as a new anabolic agent for the treatment of osteoporosis.Scl-Ab activates the canonical Wnt(cWnt)-β-catenin pathway,leading to an increase in bone formation and decrease in bone resorption.Because of its rich osteogenic effects,preclinically,Scl-Ab has shown positive effects on bone healing in rodent models;researchers have reported an increase in bone mass,mechanical strength,histological bone formation,total mineralized callus volume,bone mineral density,neovascularization,proliferating cell nuclear antigen score,and bone morphogenic protein expression at the fracture site after Scl-Ab administration.In addition,in a rat critical-size femoral-defect model,the Scl-Ab-treated group demonstrated a higher bone healing rate.On the other hand,two clinical reports have researched Scl-Ab in bone healing and failed to show positive effects in the femur and tibia.This review discusses why Scl-Ab appears to be effective in animal models of fracture healing and not in clinical cases.展开更多
文摘硬骨素(Sclerostin)是由硬化性骨病(sclerosteosis,SOST)基因编码的蛋白质,可以通过与低密度脂蛋白受体相关蛋白5/6(low density lipoprotein receptor-related protein,LRP5/6)结合达到拮抗Wnt蛋白并抑制成骨的作用,已经作为新的药物靶点用于抗骨质疏松药物研发。目前,围绕Sclerostin单克隆抗体已经进行了许多基础研究和临床研究,结果提示该类药物可以提高骨量、促进骨形成、抑制骨吸收,对于骨质疏松有一定治疗效果。但该类药物应用后的副反应,对骨折的影响等方面的研究数据尚不足,有待完善进一步研究。
文摘Promoting bone healing after a fracture has been a frequent subject of research.Recently,sclerostin antibody(Scl-Ab)has been introduced as a new anabolic agent for the treatment of osteoporosis.Scl-Ab activates the canonical Wnt(cWnt)-β-catenin pathway,leading to an increase in bone formation and decrease in bone resorption.Because of its rich osteogenic effects,preclinically,Scl-Ab has shown positive effects on bone healing in rodent models;researchers have reported an increase in bone mass,mechanical strength,histological bone formation,total mineralized callus volume,bone mineral density,neovascularization,proliferating cell nuclear antigen score,and bone morphogenic protein expression at the fracture site after Scl-Ab administration.In addition,in a rat critical-size femoral-defect model,the Scl-Ab-treated group demonstrated a higher bone healing rate.On the other hand,two clinical reports have researched Scl-Ab in bone healing and failed to show positive effects in the femur and tibia.This review discusses why Scl-Ab appears to be effective in animal models of fracture healing and not in clinical cases.
