Gülcan GÜRER, Ömer Faruk ŞENDUR, Ali AYDENİZ, Ali Hakan AYDEMİR

POSTMENOPOZAL OSTEOPOROZDA RALOKSİFEN VE KALSİTONİN TEDAVİLERİNİN BİR YILLIK SONUÇLARI

Amaç:Yaşlı osteoporozlu kişilerde özellikle de postmenopozal kadınlarda kemik kırık riski daha yüksektir.Raloksifen postmenopozal osteoporozun önlenmesinde ve tedavisinde kullanılan selektif östrojen reseptörmodülatörüdür. Kalsitonin kemik rezorpsiyonunu inhibe eder ve osteoporozlu bireylerde kullanım için önerilir.Bu çalışma postmenopozal osteoporozda raloksifen ve kalsitonin tedavilerinin etkilerini araştırmak ve kemikmineral yoğunluğu (KMY) değerlerini kıyaslamak için planlandı.Yöntem:Bu amaçla çalışmaya 44 postmenopozal osteoporozlu (raloksifen grubu: 22, kalsitonin grubu: 22) hastaalındı. Hastalar rastgele olarak iki gruba ayrıldı. Hastalarda lomber omurganın ve sol femur proksimalininKMY'u dual energy X-ray absorptiometry kullanılarak tedavi öncesi ve tedavinin birinci yılı sonunda olmaküzere iki kez ölçüldü. Birinci gruba günde 60 mg raloksifen verilirken, ikinci gruba kalsitonin 200 IU/ gün nazalolarak verildi.Bulgular:Bu tedaviler sonrası lomber omurgada raloksifenle (p=0.011) ve kalsitoninle (p=0.008) istatistikselolarak belirgin bir düzelme saptanırken, femur KMYölçümlerinde her iki grupta birinci yılın sonunda anlamlı biriyileşme saptanmadı (p>0.05). Gruplar arası kıyaslamalarda ise KMY iyileşmesi açısından bir farklılıkbulunmadı (p>0.05).Sonuç: Postmenopozal osteoporozlu hastalarda raloksifen ve kalsitonin tedavileri bir yılın sonunda trabekülerkemikte belirgin olarak iyileşme sağlarken kortikal kemikte değişiklik gözlenmedi

Anahtar Kelimeler:

Postmenopozal osteoporoz, kalsitonin, raloksifen

One Year Results of Raloxifene and Calcitonin Treatments in Postmenopausal Osteoporosis

Objective: The risk of bone fractures is higher in osteoporotic elderly people, particularly in postmenopausal women. Raloxifene is the only selective estrogen receptor modulator that has been approved for the prevention and treatment of postmenopausal osteoporosis. Calcitonin inhibits bone resorption and is recommended for use in women with osteoporosis. This study was performed to investigate the effects of raloxifene and calcitonin treatments in postmenopausal osteoporosis by comparison of the respective bone mineral density (BMD) values. Materials and methods: Forty four women with postmenopausal osteoporosis (raloxifene: 22 , calcitonin :22) were enrolled in this study. Patients were divided into two groups randomly. BMD was measured twice in the lumbar spine and left proximal femur before treatment and at the end of one year by using dual energy X-ray absorptiometry. Raloxifene was administered at a dose of 60 mg/day to the first group; calcitonin was given 200IU per day as a nasal spray. Results: Although statistically significant improvement was found in the lumbar spine with raloxifene (p=0.011) and calcitonin (p=0.008) treatments, no improvement was determined in femur BMD (p>0.05) level at end of the first year. Statistical difference was not observed between two groups (p>0.05). Conclusion: While significant improvement was produced in trabecular bone with raloxifen and calcitonin treatments at the end of one year, no change was observed in cortical bone by the two treatments.

Keywords:

Postmenopausal osteoporosis, calcitonin, raloxifene,

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