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Effects of strontium ranelate and alendronate on bone microstructure in women with osteoporosis : Results of a 2-year study

Rizzoli, R. ; Chapurlat, R. ; Laroche, J.-M ; Krieg, M. ; Thomas, T. ; Frieling, I. ; Boutroy, S. ; Laib, A. ; Bock, O. ; Felsenberg, D.

In: Osteoporosis International, 2012, vol. 23, no. 1, p. 305-315

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    Titre
    • Effects of strontium ranelate and alendronate on bone microstructure in women with osteoporosis
      Results of a 2-year study
    Auteur
    • Rizzoli, R.. Division of Bone Diseases, Department of Medical Specialties, Geneva University Hospitals and Faculty of Medicine, 1211, Geneva 14, Switzerland
    • Chapurlat, R.. INSERM U831, Université de Lyon, Edouard Herriot Hospital, Lyon, France
    • Laroche, J.-M. Rangueil Hospital, Toulouse, France
    • Krieg, M.. Department of Musculoskeletal Medicine, CHUV, Lausanne, Switzerland
    • Thomas, T.. INSERM U890, University Hospital, Saint-Etienne, France
    • Frieling, I.. Osteoporosezentrum, Hamburg, Germany
    • Boutroy, S.. INSERM U831, Université de Lyon, Edouard Herriot Hospital, Lyon, France
    • Laib, A.. SCANCO Medical AG, Bruettisellen, Switzerland
    • Bock, O.. Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Centre of Muscle and Bone Research, Free University and Humboldt University, Berlin, Germany
    • Felsenberg, D.. Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Centre of Muscle and Bone Research, Free University and Humboldt University, Berlin, Germany
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • Osteoporosis International, 2012, vol. 23, no. 1, p. 305-315. Springer-Verlag
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:317013
    Summary
    Summary: Strontium ranelate appears to influence more than alendronate distal tibia bone microstructure as assessed by high-resolution peripheral quantitative computed tomography (HR-pQCT), and biomechanically relevant parameters as assessed by micro-finite element analysis (μFEA), over 2years, in postmenopausal osteoporotic women. Introduction: Bone microstructure changes are a target in osteoporosis treatment to increase bone strength and reduce fracture risk. Methods: Using HR-pQCT, we investigated the effects on distal tibia and radius microstructure of strontium ranelate (SrRan; 2g/day) or alendronate (70mg/week) for 2years in postmenopausal osteoporotic women. This exploratory randomized, double-blind trial evaluated HR-pQCT and FEA parameters, areal bone mineral density (BMD), and bone turnover markers. Results: In the intention-to-treat population (n = 83, age: 64 ± 8years; lumbar T-score: −2.8 ± 0.8 [DXA]), distal tibia Cortical Thickness (CTh) and Density (DCort), and cancellous BV/TV increased by 6.3%, 1.4%, and 2.5%, respectively (all P < 0.005), with SrRan, but not with alendronate (0.9%, 0.4%, and 0.8%, NS) (P < 0.05 for all above between-group differences). Difference for CTh evaluated with a distance transformation method was close to significance (P = 0.06). The estimated failure load increased with SrRan (+2.1%, P < 0.005), not with alendronate (−0.6%, NS) (between-group difference, P < 0.01). Cortical stress was lower with SrRan (P < 0.05); both treatments decreased trabecular stress. At distal radius, there was no between-group difference other than DCort (P < 0.05). Bone turnover markers decreased with alendronate; bALP increased (+21%) and serum-CTX-I decreased (−1%) after 2years of SrRan (between-group difference at each time point for both markers, P < 0.0001). Both treatments were well tolerated. Conclusions: Within the constraints of HR-pQCT method, and while a possible artefactual contribution of strontium cannot be quantified, SrRan appeared to influence distal tibia bone microstructure and FEA-determined biomechanical parameters more than alendronate. However, the magnitude of the differences is unclear and requires confirmation with another method