title: Serum osteoprotegerin and RANKL are not specifically altered in women with postmenopausal osteoporosis treated with teriparatide or risedronate: a randomized, controlled trial.
abstract: Risedronate and teriparatide have opposite actions on the osteoblast-osteoclast dipole and are expected to influence the RANK/RANKL/osteoprotegerin (OPG) system. We aimed to evaluate changes in serum OPG and RANKL after risedronate or teriparatide administration in postmenopausal osteoporotic women. Seventy-four postmenopausal Caucasian women (age 64.1+/-1.0 years) were studied. Women with osteopenia served as controls (group 1, n=30). Women with osteoporosis were randomly assigned to either risedronate 35 mg once weekly (group 2, n=21) or teriparatide 20 microg once daily (group 3, n=23) for six months. Blood samples for serum RANKL, OPG, N-terminal propeptide of type 1 collagen (P1NP), and C-terminal telopeptide of type 1 collagen (CTx) were obtained before treatment and three and six months after treatment. P1NP and CTx levels remained unchanged in group 1, decreased in group 2 (p<0.001), and increased in group 3 women (p<0.001) throughout the treatment. OPG levels remained unchanged while RANKL decreased gradually in all groups (p<0.001). There was no correlation between OPG or RANKL and P1NP or CTx. Our data suggest that neither antiresorptive nor osteoanabolic therapy causes specific alterations of serum OPG/RANKL levels; therefore, these cytokines cannot substitute for the established markers of bone turnover in the monitoring of response to osteoporosis treatment.
authors.affiliation: Department of Endocrinology, Hippocration General Hospital, Thessaloniki, Greece. anastath@endo.gr
authors.forename: A D
authors.initials: AD
authors.lastname: Anastasilakis
authors.forename: D G
authors.initials: DG
authors.lastname: Goulis
authors.forename: S A
authors.initials: SA
authors.lastname: Polyzos
authors.forename: S
authors.initials: S
authors.lastname: Gerou
authors.forename: G
authors.initials: G
authors.lastname: Koukoulis
authors.forename: M
authors.initials: M
authors.lastname: Kita
authors.forename: A
authors.initials: A
authors.lastname: Avramidis
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D002118:Calcium / Q000097:blood; D024042:Collagen Type I / Q000097:blood; D012968:Etidronic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000097:blood* / Q000188:drug therapy*; D053244:Osteoprotegerin / Q000097:blood*; D053245:RANK Ligand / Q000097:blood*; D000068296:Risedronic Acid; D019379:Teriparatide / Q000627:therapeutic use*
chemical_list: D015415:Biomarkers; D050071:Bone Density Conservation Agents; D024042:Collagen Type I; D053244:Osteoprotegerin; D053245:RANK Ligand; C505688:TNFSF11 protein, human; D019379:Teriparatide; D000068296:Risedronic Acid; D012968:Etidronic Acid; D002118:Calcium