title: Strontium ranelate effect on bone mineral density is modified by previous bisphosphonate treatment.
abstract: The aim of this study was to evaluate the effect of strontium ranelate (SrR) on bone mineral density (BMD) and bone turnover markers after 1 year of treatment. Additionally, the effect of SrR in bisphosphonate-naïve patients (BP-naïve) compared to patients previously treated with bisphosphonates (BP-prior) was analyzed. This retrospective study included 482 postmenopausal women treated with SrR (2 g/day) for 1 year in ten Argentine centers; 41 patients were excluded due to insufficient data, while 441 were included. Participants were divided according to previous bisphosphonate treatment in two groups: BP-naïve (n = 87) and BP-prior (n = 350). Data are expressed as mean ± SEM. After 1 year of treatment with SrR the bone formation markers total alkaline phosphatase and osteocalcin were increased (p < 0.0001), while the bone resorption marker s-CTX was decreased (p = 0.0579). Also increases in BMD at the lumbar spine (LS, 3.73%), femoral neck (FN, 2.00%) and total hip (TH, 1.54%) [p < 0.0001] were observed. These increments were significant (p < 0.0001) both among BP-naïve and BP-prior patients. Interestingly, the change in BMD after 1 year of SrR treatment was higher in BP-naïve patients: LS: BP-naïve = 4.58 ± 0.62%; BP-prior = 3.45 ± 0.28% (p = 0.078). FN: BP-naïve = 2.79 ± 0.56%; BP-prior = 2.13 ± 0.29% (p = 0.161). TH: BP-naïve = 3.01 ± 0.55%; BP-prior = 1.22 ± 0.27% (p = 0.0006). SrR treatment increased BMD and bone formation markers and decreased a bone resorption marker in the whole group, with better response in BP-naïve patients.
authors.affiliation: Laboratorio de Biología Ósea, Facultad de Ciencias Médicas, Universidad Nacional de Rosario, Rosario, Argentina.
authors.forename: Lucas R
authors.initials: LR
authors.lastname: Brun
authors.affiliation: Servicio de Endocrinología del Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
authors.forename: Ana M
authors.initials: AM
authors.lastname: Galich
authors.affiliation: CESAN, Buenos Aires. Instituto de la Mujer, Campana, Argentina.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Vega
authors.affiliation: Consultorios de Investigación Clínica Endocrinológica y del Metabolismo Óseo (CICEMO), Buenos Aires, Argentina.
authors.forename: Helena
authors.initials: H
authors.lastname: Salerni
authors.affiliation: Consultorios Asociados de Endocrinología Dra. Laura Maffei, Buenos Aires, Argentina.
authors.forename: Laura
authors.initials: L
authors.lastname: Maffei
authors.affiliation: Consultorios Asociados de Endocrinología Dra. Laura Maffei, Buenos Aires, Argentina.
authors.forename: Valeria
authors.initials: V
authors.lastname: Premrou
authors.affiliation: Consultorios de Investigación Clínica Endocrinológica y del Metabolismo Óseo (CICEMO), Buenos Aires, Argentina.
authors.forename: Pablo R
authors.initials: PR
authors.lastname: Costanzo
authors.affiliation: Instituto de Investigaciones Metabólicas Dr. Zanchetta, Buenos Aires, Argentina.
authors.forename: Marcelo A
authors.initials: MA
authors.lastname: Sarli
authors.affiliation: Instituto de Investigaciones Metabólicas Dr. Zanchetta, Buenos Aires, Argentina.
authors.forename: Paula
authors.initials: P
authors.lastname: Rey
authors.affiliation: Hospital César Milstein, Buenos Aires, Argentina.
authors.forename: María S
authors.initials: MS
authors.lastname: Larroudé
authors.affiliation: Centro Tiempo, Buenos Aires, Argentina.
authors.forename: María S
authors.initials: MS
authors.lastname: Moggia
authors.affiliation: Laboratorio de Biología Ósea, Facultad de Ciencias Médicas, Universidad Nacional de Rosario, Rosario, Argentina ; Centro de Reumatología, Rosario, Argentina.
authors.forename: María L
authors.initials: ML
authors.lastname: Brance
authors.affiliation: Centro de Endocrinología, Rosario, Argentina.
authors.forename: Ariel
authors.initials: A
authors.lastname: Sánchez
keywords: Bisphosphonate-naïve; Bone mineral density; Strontium ranelate