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

Rizzoli R, Laroche M, Krieg MA, Frieling I, Thomas T, Delmas P, Felsenberg D - Rheumatol. Int. (2010)

Bottom Line: We compared the effects of strontium ranelate and alendronate on distal tibia microstructure over 2 years using HR-pQCT.No significant changes were 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.

View Article: PubMed Central - PubMed

Affiliation: Division of Bone Diseases, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, 1211, Geneva 14, Switzerland. Rene.Rizzoli@unige.ch

ABSTRACT
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 2 years using HR-pQCT. In this pre-planned, interim, intention-to-treat analysis at 12 months, 88 osteoporotic postmenopausal women (mean age 63.7 +/- 7.4) were randomized to strontium ranelate 2 g/day or alendronate 70 mg/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.

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Change from baseline over time (median, Q1 and Q3) of b-ALP (a) and S-CTX (b) in the strontium ranelate and alendronate groups
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Fig2: Change from baseline over time (median, Q1 and Q3) of b-ALP (a) and S-CTX (b) in the strontium ranelate and alendronate groups

Mentions: Lumbar, total hip and femoral neck aBMD increased in both groups and did not differ between groups (Table 3). In the strontium ranelate group, b-ALP increased by a median of 0.55 ng/mL (+4.1%, P = 0.095) at 3 months and 0.6 ng/mL (+5%, P = 0.082) at 12 months. S-CTX remained unchanged (median, −0.04 ng/mL, −7%, P = 0.250). In the alendronate group, both b-ALP and S-CTX decreased (median, −4.7 ng/mL, −35%, P ≤ 0.001, and −0.36 ng/mL, −58%, P < 0.001, respectively). Between-group differences at 1 year were 40 and 55%, respectively (P ≤ 0.001 each) (Fig. 2).Table 3


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

Rizzoli R, Laroche M, Krieg MA, Frieling I, Thomas T, Delmas P, Felsenberg D - Rheumatol. Int. (2010)

Change from baseline over time (median, Q1 and Q3) of b-ALP (a) and S-CTX (b) in the strontium ranelate and alendronate groups
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2908746&req=5

Fig2: Change from baseline over time (median, Q1 and Q3) of b-ALP (a) and S-CTX (b) in the strontium ranelate and alendronate groups
Mentions: Lumbar, total hip and femoral neck aBMD increased in both groups and did not differ between groups (Table 3). In the strontium ranelate group, b-ALP increased by a median of 0.55 ng/mL (+4.1%, P = 0.095) at 3 months and 0.6 ng/mL (+5%, P = 0.082) at 12 months. S-CTX remained unchanged (median, −0.04 ng/mL, −7%, P = 0.250). In the alendronate group, both b-ALP and S-CTX decreased (median, −4.7 ng/mL, −35%, P ≤ 0.001, and −0.36 ng/mL, −58%, P < 0.001, respectively). Between-group differences at 1 year were 40 and 55%, respectively (P ≤ 0.001 each) (Fig. 2).Table 3

Bottom Line: We compared the effects of strontium ranelate and alendronate on distal tibia microstructure over 2 years using HR-pQCT.No significant changes were 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.

View Article: PubMed Central - PubMed

Affiliation: Division of Bone Diseases, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, 1211, Geneva 14, Switzerland. Rene.Rizzoli@unige.ch

ABSTRACT
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 2 years using HR-pQCT. In this pre-planned, interim, intention-to-treat analysis at 12 months, 88 osteoporotic postmenopausal women (mean age 63.7 +/- 7.4) were randomized to strontium ranelate 2 g/day or alendronate 70 mg/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.

Show MeSH
Related in: MedlinePlus