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Relationship between 3-month changes in biochemical markers of bone remodelling and changes in bone mineral density and fracture incidence in patients treated with strontium ranelate for 3 years

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Abstract

Summary

From two randomised controlled trials, it is shown that 3-month changes in biochemical markers of bone formation (bone-specific alkaline phosphatase and C-terminal propeptide of type I procollagen) were associated with 3-year bone mineral density (BMD) changes, but not fracture incidence in patients treated with strontium ranelate.

Introduction

The purpose of this study was to assess if short-term change in biochemical markers of bone remodelling is associated with long-term BMD change and fracture incidence observed during treatment with strontium ranelate.

Methods

From the SOTI and TROPOS trials, bone-specific alkaline phosphatase (BALP), C-terminal propeptide of type I procollagen (PICP), serum C-terminal telopeptides (S-CTX) and urine N-terminal telopeptides of type I collagen (U-NTX) were assessed at baseline and after 3 months.

Results

Two thousand three hundred seventy-three women were included in this study. Multiple regression analysis showed that 3-month changes in PICP and BALP but not s-CTX I nor s-NTX I were significantly (p < 0.001) associated with 3-year BMD changes at the lumbar spine and the femoral neck. Changes in s-CTX I, PICP and BALP were significantly associated with change in total proximal femur BMD. Changes in biochemical markers explain less than 8% of the BMD changes. The 3-month changes in BALP, PICP s-CTX I and s-NTX I were not significantly associated with fracture incidence.

Conclusions

Short-term changes in biochemical markers of bone formation are associated with future BMD changes in patients treated with strontium ranelate, suggesting a bone-forming activity of this treatment, but are not appropriate to monitor the efficacy of strontium ranelate at the individual level.

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Acknowledgement

This study has been funded in part by a research grant from Servier.

Conflicts of interest

O.B., R.R., S.O. and J.Y.R. have received consulting fees or lecture fees from Servier. Other authors have no disclosures.

Author information

Authors and Affiliations

  1. Department of Public Health, Epidemiology and Health Economics, CHU Sart-Tilman, University of Liège, Bât B23, 4000, Liège, Belgium

    O. Bruyère, J. Collette, C. Decock, J. Detilleux & J.-Y. Reginster

  2. Department of Rehabilitation and Geriatrics, Geneve, Switzerland

    R. Rizzoli

  3. Centre for Metabolic Bone, Istituto Auxologico Italiano, Milan, Italy

    S. Ortolani

  4. Department of Rheumatology, Cochin Hospital, René Descartes University, Paris, France

    C. Cormier

Authors
  1. O. Bruyère
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  2. J. Collette
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  3. R. Rizzoli
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  4. C. Decock
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  5. S. Ortolani
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  6. C. Cormier
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  7. J. Detilleux
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  8. J.-Y. Reginster
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Corresponding author

Correspondence to O. Bruyère.

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Bruyère, O., Collette, J., Rizzoli, R. et al. Relationship between 3-month changes in biochemical markers of bone remodelling and changes in bone mineral density and fracture incidence in patients treated with strontium ranelate for 3 years. Osteoporos Int 21, 1031–1036 (2010). https://doi.org/10.1007/s00198-009-1078-8

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  • DOI: https://doi.org/10.1007/s00198-009-1078-8

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