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

Laroche, Michel
Krieg, Marc-Antoine
Frieling, Isolde
Thomas, Thierry
Delmas, Pierre
Felsenberg, Dieter
Published in Rheumatology International. 2010, vol. 30, no. 10, p. 1341-1348
Collection Open Access - Licence nationale Springer
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.
Keywords Alendronate/*therapeutic useBone Density/drug effectsBone Density Conservation Agents/*therapeutic useFemaleFemur Neck/drug effects/metabolism/radiographyFractures, Bone/prevention & controlHip Joint/drug effects/metabolism/radiographyHumansMiddle AgedOrganometallic Compounds/*therapeutic useOsteogenesis/drug effects/physiologyOsteoporosis, Postmenopausal/*drug therapy/metabolism/pathologySpine/drug effects/metabolism/radiographyThiophenes/*therapeutic useTibia/*drug effects/pathologyTomography, X-Ray Computed
PMID: 20512336
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Research group Nutrition et os (66)
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RIZZOLI, René et al. Strontium ranelate and alendronate have differing effects on distal tibia bone microstructure in women with osteoporosis. In: Rheumatology International, 2010, vol. 30, n° 10, p. 1341-1348. doi: 10.1007/s00296-010-1542-y https://archive-ouverte.unige.ch/unige:21257

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Deposited on : 2012-05-23

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