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Strontium ranelate and alendronate have differing effects on distal tibia bone microstructure in women with osteoporosis

Rizzoli, René ; Laroche, Michel ; Krieg, Marc-Antoine ; Frieling, Isolde ; Thomas, Thierry ; Delmas, Pierre ; Felsenberg, Dieter

In: Rheumatology International, 2010, vol. 30, no. 10, p. 1341-1348

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    Titre
    • Strontium ranelate and alendronate have differing effects on distal tibia bone microstructure in women with osteoporosis
    Auteur
    • Rizzoli, René. Division of Bone Diseases, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, 1211, Geneva 14, Switzerland
    • Laroche, Michel. Rangueil Hospital, Toulouse, France
    • Krieg, Marc-Antoine. Department of Muskuloskeletal Medicine, CHUV, Lausanne, Switzerland
    • Frieling, Isolde. Osteoporosezentrum, Hamburg, Germany
    • Thomas, Thierry. INSERM U890, University Hospital, Saint-Etienne, France
    • Delmas, Pierre. Edouard Herriot Hospital, Lyon, France
    • Felsenberg, Dieter. Charité Campus Benjamin Franklin, Berlin, Germany
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • Rheumatology International, 2010, vol. 30, no. 10, p. 1341-1348. Springer-Verlag
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:317339
    Summary
    The structural basis of the antifracture efficacy of strontium ranelate and alendronate is incompletely understood. We compared the effects of strontium ranelate and alendronate on distal tibia microstructure over 2years using HR-pQCT. In this pre-planned, interim, intention-to-treat analysis at 12months, 88 osteoporotic postmenopausal women (mean age 63.7±7.4) were randomized to strontium ranelate 2g/day or alendronate 70mg/week in a double-placebo design. Primary endpoints were changes in microstructure. Secondary endpoints included lumbar and hip areal bone mineral density (aBMD), and bone turnover markers. This trial is registered with http://www.controlled-trials.com, number ISRCTN82719233. Baseline characteristics of the two groups were similar. Treatment with strontium ranelate was associated with increases in mean cortical thickness (CTh, 5.3%), cortical area (4.9%) and trabecular density (2.1%) (all P<0.001, except cortical area P=0.013). No significant changes were observed with alendronate. Between-group differences in favor of strontium ranelate were observed for CTh, cortical area, BV/TV and trabecular density (P=0.045, 0.041, 0.048 and 0.035, respectively). aBMD increased to a similar extent with strontium ranelate and alendronate at the spine (5.7% versus 5.1%, respectively) and total hip (3.3% versus 2.2%, respectively). No significant changes were observed in remodeling markers with strontium ranelate, while suppression was observed with alendronate. Within the methodological constraints of HR-pQCT through its possible sensitivity to X-ray attenuation of different minerals, strontium ranelate had greater effects than alendronate on distal tibia cortical thickness and trabecular volumetric density