JP2010275309A - エルデカルシトールを含有する重症骨粗鬆症患者での非外傷性椎体骨折抑制剤 - Google Patents
エルデカルシトールを含有する重症骨粗鬆症患者での非外傷性椎体骨折抑制剤 Download PDFInfo
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- JP2010275309A JP2010275309A JP2010103918A JP2010103918A JP2010275309A JP 2010275309 A JP2010275309 A JP 2010275309A JP 2010103918 A JP2010103918 A JP 2010103918A JP 2010103918 A JP2010103918 A JP 2010103918A JP 2010275309 A JP2010275309 A JP 2010275309A
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- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/59—Compounds containing 9, 10- seco- cyclopenta[a]hydrophenanthrene ring systems
- A61K31/593—9,10-Secocholestane derivatives, e.g. cholecalciferol, i.e. vitamin D3
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P19/00—Drugs for skeletal disorders
- A61P19/08—Drugs for skeletal disorders for bone diseases, e.g. rachitism, Paget's disease
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P19/00—Drugs for skeletal disorders
- A61P19/08—Drugs for skeletal disorders for bone diseases, e.g. rachitism, Paget's disease
- A61P19/10—Drugs for skeletal disorders for bone diseases, e.g. rachitism, Paget's disease for osteoporosis
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Abstract
【解決手段】エルデカルシトールを含んでなる、大腿部骨密度のTスコアが−2.5SD以下でかつ脆弱性骨折を有する重症骨粗鬆症患者の非外傷性椎体骨折を抑制するための医薬組成物。
【選択図】なし
Description
エルデカルシトール(eldecalcitol)とは、開発コード「ED−71」の化合物であり、化学名:(1R,2R,3R,5Z,7E)−2−(3−ヒドロキシプロピルオキシ)−9,10−セココレスタ−5,7,10(19)−トリエン−1,3,25−トリオールを有する化合物である。
特発性骨粗鬆症は、小児や正常の性腺機能のある男女の青年に起こり、I型骨粗鬆症(閉経後骨粗鬆症)」は、51〜75歳の間に発生し、女性は男性の6倍ほどかかりやすいが、性腺摘除後または血清中のテストステロン濃度の低い男性にも発生する。II型骨粗鬆症(退行性または老人性骨粗鬆症)は、老化の正常な経過などに関連し、一般的に60歳以上の患者に発症する。高齢女性ではI型とII型がしばしば一緒に起こる。
世界保健機構(WHO:World Health Organization)の診断基準によれば、骨粗鬆症の重症度は、骨密度及び脆弱性骨折数によって定義される。この基準において、「正常」は、若年成人基準の平均(Young Adult Mean, YAM)に対して骨密度のTスコアが−1SD以内と定義され、以下、「低骨量(骨量減少)」は、骨密度のTスコアが−1〜−2.5SDであると定義され、「骨粗鬆症」は、骨密度のTスコアが−2.5SD以下であると定義され、そして、「重症骨粗鬆症」は、骨密度のTスコアが−2.5SD以下で、かつ1箇所以上の脆弱性骨折を有する、と定義される。ここで、SDは標準偏差値である。
相当な期間とは、患者の骨密度および骨強度を増大させて骨折しにくくさせるのに十分な長さの時間量を意味する。本発明における相当な期間とは、少なくとも24週以上、より好ましくは48週以上、さらに好ましくは144週以上である。
原発性骨粗鬆症患者を対象として、エルデカルシトールの有効性を、アルファカルシドールを対照とした無作為割付二重盲検群間比較試験により検討した。
A群:大腿骨近位部骨密度のTスコアが−2.5SD以下でかつ脆弱性椎体骨折あり;
B群:大腿骨近位部骨密度のTスコアが−2.5SD以下でかつ脆弱性椎体骨折2箇所以上あり。
エルデカルシトール(ED−71):0.75μg/日、経口投与
アルファカルシドール(ALF):1.0μg/日、経口投与。
投与期間:エルデカルシトール(ED−71)、アルファカルシドール(ALF)ともに144週継続投与(後観察4週間)
新規椎体骨折の評価:投与開始時、6ヵ月、1年、2年、3年または随時に椎体の正面及び側面から撮影した胸・腰椎X線写真を内科医、整形外科医、放射線科医の3名の判定委員のうち少なくとも2名が独立して第4胸椎から第4腰椎の計13椎体をSQグレードに準じ読影し、投与開始時と比べ変形が認められた場合には、椎体の前縁高、中央高、後縁高を計測し、投与前に比べ15%かつ4mm以上の減少が認められた椎体を新規椎体骨折と評価した。なお、独立して行った2名以上の判定に不一致が認められた場合は、上記の3名で再度協議を行い、新規椎体骨折の有無を決定した。
エルデカルシトール(ED−71):0.5μg/日、経口投与
アルファカルシドール(ALF):0.5μg/日、経口投与。
コックス回帰とは、イベントが起こるまでの期間に何らかの別の要因が与える効果を調べたいときに用いる方法であり、それらが基準となる個体のハザードに対して、比例定数の形でかかるとする比例ハザード性を仮定する方法である。ハザードとは、ある時点まで新たに非外傷性椎体を骨折していなかった者が、その時点において非外傷性椎体骨折する確率(瞬間新規非外傷性椎体骨折確率)を表す。ハザード比とは、2群のハザードの比をいう。すなわち、一方を基準にした場合に他方が何倍の非外傷性新規椎体骨折確率であるかを表している。
Claims (4)
- 大腿部骨密度のTスコアが−2.5SD以下でかつ脆弱性骨折を有する重症骨粗鬆症患者の非外傷性椎体骨折を抑制するためのエルデカルシトールを含んでなる医薬組成物。
- 脆弱性骨折が椎体骨折である、請求項1に記載の組成物。
- 重症骨粗鬆症患者が原発性重症骨粗鬆症患者である、請求項1又は2に記載の組成物。
- エルデカルシトールが0.75μg/日の用量で経口投与される、請求項3に記載の組成物。
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TW201105333A (en) * | 2009-04-28 | 2011-02-16 | Chugai Pharmaceutical Co Ltd | Agent for preventing non-traumatic vertebral fracture in severe osteoporosis patients which comprises eldecalcitol |
JP5969161B2 (ja) * | 2009-04-28 | 2016-08-17 | 中外製薬株式会社 | エルデカルシトールを含有する前腕部骨折抑制剤 |
Citations (3)
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JPS63107929A (ja) * | 1986-06-05 | 1988-05-12 | Chugai Pharmaceut Co Ltd | 新規ビタミンd↓3誘導体を有効成分とする医薬 |
WO2010126093A1 (ja) * | 2009-04-28 | 2010-11-04 | 中外製薬株式会社 | エルデカルシトールを含有する前腕部骨折抑制剤 |
WO2010126094A1 (ja) * | 2009-04-28 | 2010-11-04 | 中外製薬株式会社 | エルデカルシトールを含有する重症骨粗鬆症患者での非外傷性椎体骨折抑制剤 |
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JPS63107929A (ja) * | 1986-06-05 | 1988-05-12 | Chugai Pharmaceut Co Ltd | 新規ビタミンd↓3誘導体を有効成分とする医薬 |
WO2010126093A1 (ja) * | 2009-04-28 | 2010-11-04 | 中外製薬株式会社 | エルデカルシトールを含有する前腕部骨折抑制剤 |
WO2010126094A1 (ja) * | 2009-04-28 | 2010-11-04 | 中外製薬株式会社 | エルデカルシトールを含有する重症骨粗鬆症患者での非外傷性椎体骨折抑制剤 |
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Title |
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JPN6010040886; KUBODERA,N. et al: 'A new active vitamin D analog, ED-71, causes increase in bone mass with preferential effects on bone' J Cell Biochem Vol.88, No.2, 2003, p.286-9 * |
JPN6010040887; TAKAHASHI,F. et al: 'ED-71' Bone(Osaka, Japan) Vol.19, No.1, 2005, p.67-70 * |
JPN6010040889; UCHIYAMA,Y. et al: 'ED-71, a vitamin D analog, is a more potent inhibitor of bone resorption than alfacalcidol in an est' Bone Vol.30, No.4, 2002, p.582-8 * |
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