Osteoporosis International

, Volume 23, Issue 1, pp 295–303

The effect of prior bisphosphonate therapy on the subsequent therapeutic effects of strontium ranelate over 2 years

  • E. T. Middleton
  • S. A. Steel
  • M. Aye
  • S. M. Doherty
Original Article

DOI: 10.1007/s00198-011-1547-8

Cite this article as:
Middleton, E.T., Steel, S.A., Aye, M. et al. Osteoporos Int (2012) 23: 295. doi:10.1007/s00198-011-1547-8

Abstract

Summary

Many osteoporotic women prescribed strontium ranelate have previously received bisphosphonates. Prior bisphosphonate use blunted the spinal bone mineral density (BMD) response for 6 months. Hip BMD was blunted to a degree for 2 years, although there was an overall increase in hip BMD in contrast to the heel where BMD did not increase.

Introduction

Many osteoporotic women commenced on strontium ranelate have already received treatment with bisphosphonates. This study investigates whether prior bisphosphonate use impairs the subsequent therapeutic response to strontium ranelate.

Methods

Women were recruited who were either bisphosphonate naïve or currently receiving a bisphosphonate. All women received strontium ranelate and were followed up for 2 years.

Results

One hundred and twenty women were recruited. After 2 years, the bisphosphonate-naïve group had significant BMD increases of 8.9%, 6.0% and 6.4% at the spine, hip and heel, respectively. In the prior bisphosphonate group, BMD increased significantly at the spine (4.0%) and hip (2.5%) but not at the heel. At all time points at all sites, the BMD increase was greater in the bisphosphonate-naïve group. BMD at the spine did not increase during the first 6 months in the prior bisphosphonate group but then increased in parallel with the bisphosphonate-naïve group. In contrast, the difference between the two groups in hip BMD continued to increase throughout the 2 years. P1NP was suppressed in the prior bisphosphonate group for the first 6 months.

Conclusions

After bisphosphonate exposure, the BMD response to strontium ranelate is blunted for only 6 months at the spine. At the hip, a degree of blunting was observed over 2 years, although there was an overall increase in hip BMD in contrast to the heel where no increase in BMD was observed.

Keywords

Bisphosphonate Bone mineral density Osteoporosis Strontium ranelate 

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2011

Authors and Affiliations

  • E. T. Middleton
    • 1
  • S. A. Steel
    • 1
  • M. Aye
    • 1
  • S. M. Doherty
    • 1
  1. 1.Centre for Metabolic Bone DiseaseHull Royal InfirmaryHullUK