No difference between strontium ranelate (SR) and calcium/vitamin D on bone turnover markers in women with established osteoporosis previously treated with teriparatide: a randomized controlled trial.
Objective To evaluate the effect of strontium ranelate (SR) on bone turnover markers in women with established osteoporosis previously treated with teriparatide (TPTD--recombinant human PTH 1-34). DESIGN PATIENTS: Twenty-two postmenopausal Caucasian women (aged 65.7 +/- 1.7 years) with established osteoporosis previously treated with TPTD 20 microg daily for 18 months were randomly assigned to receive either SR (SR group, n = 11) or calcium and vitamin D (control group, n = 11).


METHODS
Blood samples for serum N-terminal propeptide of type 1 collagen (P1NP), C-terminal telopeptide of type 1 collagen (CTx) and total alkaline phosphatase (ALP) were obtained from all women before (pre-TPTD) and after (post-TPTD) TPTD administration, as well as 6 months after SR or calcium/vitamin D administration (post-SR/Ca).


RESULTS
Serum P1NP, CTx and total ALP increased significantly after TPTD treatment and decreased at the end of the study in both SR and control groups, with no difference between them.


CONCLUSIONS
SR following TPTD administration acts predominantly as an antiresorptive agent with no evidence of additional osteoanabolic action. In this setting, SR is not more effective than Ca/vitamin D as far as bone turnover markers are concerned.
Anastasilakis
Athanasios D
AD
Department of Endocrinology, Hippocration General Hospital, Thessaloniki, Greece. anastath@endo.gr
Goulis
Dimirtios G
DG
Polyzos
Stergios A
SA
Gerou
Spiridon
S
Ballaouri
Iris
I
Efstathiadou
Zoe
Z
Kita
Marina
M
Avramidis
Avraam
A
D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D001842:Bone and Bones / Q000378:metabolism*; D002118:Calcium / Q000627:therapeutic use*; D024042:Collagen Type I / Q000097:blood; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008875:Middle Aged; D009942:Organometallic Compounds / Q000627:therapeutic use*; D015663:Osteoporosis, Postmenopausal / Q000097:blood / Q000188:drug therapy*; D010455:Peptides / Q000097:blood; D019379:Teriparatide / Q000627:therapeutic use*; D013876:Thiophenes / Q000627:therapeutic use*; D016896:Treatment Outcome; D014807:Vitamin D / Q000627:therapeutic use*
D050071:Bone Density Conservation Agents; D024042:Collagen Type I; D009942:Organometallic Compounds; D010455:Peptides; D013876:Thiophenes; C052929:collagen type I trimeric cross-linked peptide; C081587:strontium ranelate; D019379:Teriparatide; D014807:Vitamin D; D000469:Alkaline Phosphatase; D002118:Calcium