title: Co-treatment of PTH with osteoprotegerin or alendronate increases its anabolic effect on the skeleton of oophorectomized mice.
abstract: We examined the effects of 60 days of co-treatment of PTH with either OPG or alendronate in oophorectomized mice. Compared with PTH alone, co-treatment of PTH with either of these two mechanistically distinct anti-catabolics improved bone volume, mechanical strength, and appendicular and axial mineralization and prolonged the beneficial effect of PTH on BMD.
  
  
  BACKGROUND
  Conflicting evidence exists as to whether the anabolic effect of PTH is inhibited by the action of anti-catabolics. To examine this issue, we assessed the effects of alendronate and osteoprotegerin (OPG), two anti-catabolics with different modes of action, on the anabolic activity of PTH(1-34) in the skeleton of 4-month-old oophorectomized mice.
  
  
  METHODS
  Mice treated with vehicle alone (PBS), alendronate alone (100 microg/kg/week), OPG alone (10 mg/kg twice a week), or PTH alone (80 microg/kg/day) were compared with each other and with animals administered PTH plus alendronate or PTH plus OPG. We assessed lumbar spine and femoral BMD at 0, 30, and 60 days. Contact radiography, histology, and histomorphometry, three-point bending assay of the femur, and serum osteocalcin and TRACP5b assays were performed at 2 months.
  
  
  RESULTS
  Although alendronate and OPG each suppressed bone turnover, at the doses used, this was more profound with OPG. Increases in lumbar spine and femoral BMD and in trabecular bone volume were at least as great with OPG as with alendronate, and mechanical indices of femoral bone strength improved only with OPG. Both produced a plateau in spine and femoral BMD increases by 30 days. Co-treatment of PTH with each anti-catabolic produced additive increases in BMD in the femur and supra-additive increases in the lumbar spine with no plateau effects. Neither anti-catabolic impeded the PTH-induced increase in bone volume or the increase in mechanical strength of the femur.
  
  
  CONCLUSIONS
  These studies show that the highly potent anti-catabolic OPG can produce dramatic increases in BMD and bone strength; that the temporal pattern of activity of bone formation and resorption modulators may have major influence on net skeletal accrual; and that, depending on timing, inhibition of osteoclastic activity may markedly augment the anabolic action of PTH.
authors.affiliation: Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada.
authors.forename: Rana
authors.initials: R
authors.lastname: Samadfam
authors.forename: Qingwen
authors.initials: Q
authors.lastname: Xia
authors.forename: David
authors.initials: D
authors.lastname: Goltzman
mesh_terms: D019386:Alendronate / Q000494:pharmacology*; D000818:Animals; D001842:Bone and Bones / Q000187:drug effects / Q000502:physiology*; D005260:Female; D005269:Femur / Q000187:drug effects / Q000502:physiology; D051379:Mice; D008810:Mice, Inbred C57BL; D053244:Osteoprotegerin / Q000494:pharmacology*; D010052:Ovariectomy; D010281:Parathyroid Hormone / Q000494:pharmacology*; D013131:Spine / Q000187:drug effects / Q000502:physiology*
chemical_list: D053244:Osteoprotegerin; D010281:Parathyroid Hormone; D019386:Alendronate