Effects of short-term use of ibuprofen or acetaminophen on bone resorption in healthy men: a double-blind, placebo-controlled pilot study.
Prostaglandins are known to be involved in the metabolism of bone, having a significant influence on bone resorption in cases of bone pathology. We therefore investigated the short-term effects of two commonly used nonsteroidal anti-inflammatory drugs (NSAIDs), ibuprofen and acetaminophen (paracetamol), on bone resorption in healthy men. In a randomized, double-blind pilot study, 28 healthy, age- and weight-matched male volunteers were treated with ibuprofen (n = 10), acetaminophen (n = 9), or a placebo (n = 9) for 3 days. As an indication of bone resorption rate, levels of the biochemical bone markers N-telopeptide (NTx) and free deoxypyridinoline (D-Pyr) were measured in urine. Differences in resorption marker levels pre- and post-NSAID use were then compared between groups. We found that NTx concentrations in the acetaminophen group were lower than placebo (p = 0.048), whereas NTx levels in the ibuprofen group were higher than in the acetaminophen group (p = 0.016). By contrast, D-Pyr concentrations in the ibuprofen group were significantly lower than in the placebo group (p = 0.009). A comparison of the percentage changes of D-Pyr:NTx ratios found that the ratio in the ibuprofen group was significantly lower than that of both the control (p = 0.0065) and acetaminophen (p = 0.01) groups. These results show the differential effects of ibuprofen and acetaminophen on urinary excretion of peptide-bound and free deoxypyridinoline cross-links of type I collagen. Short-term ibuprofen use may alter the renal handling of collagen cross-links and increase bone resorption to a greater extent than acetaminophen in normal men.
Head
J E
JE
School of Human Biosciences, La Trobe University, VIC, Bundoora, Australia.
Bryant
B J
BJ
Grills
B L
BL
Ebeling
P R
PR
D000082:Acetaminophen / Q000008:administration & dosage*; D000328:Adult; D000596:Amino Acids / Q000378:metabolism; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D001862:Bone Resorption / Q000188:drug therapy* / Q000378:metabolism*; D003094:Collagen / Q000378:metabolism; D024042:Collagen Type I; D003432:Cross-Linking Reagents / Q000378:metabolism; D004311:Double-Blind Method; D006801:Humans; D007052:Ibuprofen / Q000008:administration & dosage*; D007668:Kidney / Q000187:drug effects / Q000378:metabolism; D008297:Male; D010455:Peptides / Q000378:metabolism; D010865:Pilot Projects
D000596:Amino Acids; D000894:Anti-Inflammatory Agents, Non-Steroidal; D024042:Collagen Type I; D003432:Cross-Linking Reagents; D010455:Peptides; C052929:collagen type I trimeric cross-linked peptide; D000082:Acetaminophen; C036020:deoxypyridinoline; D003094:Collagen; D007052:Ibuprofen