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01-01-2012 | Original Article

Effects of strontium ranelate and alendronate on bone microstructure in women with osteoporosis

Results of a 2-year study

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

Published in: Osteoporosis International | Issue 1/2012

Abstract

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 2 years, 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; 2 g/day) or alendronate (70 mg/week) for 2 years 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 ± 8 years; 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 2 years 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.

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Title: Effects of strontium ranelate and alendronate on bone microstructure in women with osteoporosis
Results of a 2-year study
Authors: R. Rizzoli
R. D. Chapurlat
J.-M. Laroche
M. A. Krieg
T. Thomas
I. Frieling
S. Boutroy
A. Laib
O. Bock
D. Felsenberg
Publication date: 01-01-2012
Publisher: Springer-Verlag
Published in: Osteoporosis International / Issue 1/2012
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-011-1758-z

At a glance: The STEP trials

Springer Medicine

Effects of strontium ranelate and alendronate on bone microstructure in women with osteoporosis

Results of a 2-year study

Abstract

Summary

Introduction

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Summary

Introduction

Methods

Results

Conclusions

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