title: Effects of strontium ranelate on bone mass and bone turnover in women with thalassemia major-related osteoporosis.
abstract: Subjects affected by thalassemia major (TM) often have reduced bone mass and increased fracture risk. Strontium ranelate (SrR) is an effective treatment for postmenopausal and male osteoporosis. To date, no data exist on the use of SrR in the treatment of TM-related osteoporosis. Our aim was to evaluate the effects of SrR on bone mineral density (BMD), bone turnover markers and inhibitors of Wnt signaling (sclerostin and DKK-1). Twenty-four TM osteoporotic women were randomized to receive daily SrR 2 g or placebo in addition to calcium carbonate (1,000 mg) and vitamin D (800 IU). BMD at the lumbar spine and femoral neck, bone turnover markers (C-terminal telopeptide of procollagen type I [CTX], bone-specific alkaline phosphatase [BSAP]) and insulin-like growth factor-1 (IGF-1), sclerostin and DKK-1 were assessed at baseline and after 24 months. Back pain was measured by visual analog scale (VAS) every 6 months. After 24 months, TM women treated with SrR had increased their spine BMD values in comparison to baseline (p < 0.05). Moreover, they also exhibited a reduction of CTX and sclerostin levels (but not DKK-1) and exhibited an increase of BSAP and IGF-1 (p < 0.05); however, no significant changes were observed in the placebo group. In the SrR group, a reduction of back pain was observed after 18 months in comparison to baseline (p < 0.05) and after 24 months in comparison to placebo (p < 0.05). Our study reports for the first time the effects of SrR in the treatment of TM-related osteoporosis. SrR treatment improved BMD and normalized bone turnover markers, as well as lowering sclerostin serum levels.
authors.affiliation: Department of Clinical and Experimental Medicine, University Hospital of Messina, A.O.U. Policlinico "G. Martino", Via C. Valeria, 98125, Messina, Italy.
authors.forename: Nunziata
authors.initials: N
authors.lastname: Morabito
authors.affiliation: Department of Clinical and Experimental Medicine, University Hospital of Messina, A.O.U. Policlinico "G. Martino", Via C. Valeria, 98125, Messina, Italy. catalanoa@unime.it.
authors.forename: Antonino
authors.initials: A
authors.lastname: Catalano
authors.affiliation: Department of Medical and Pediatric Sciences, University of Catania, Catania, Italy.
authors.forename: Agostino
authors.initials: A
authors.lastname: Gaudio
authors.affiliation: Department of Clinical and Experimental Medicine, University Hospital of Messina, A.O.U. Policlinico "G. Martino", Via C. Valeria, 98125, Messina, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Morini
authors.affiliation: Department of Clinical and Experimental Medicine, University Hospital of Messina, A.O.U. Policlinico "G. Martino", Via C. Valeria, 98125, Messina, Italy.
authors.forename: Lucia Maria
authors.initials: LM
authors.lastname: Bruno
authors.affiliation: Department of Clinical and Experimental Medicine, University Hospital of Messina, A.O.U. Policlinico "G. Martino", Via C. Valeria, 98125, Messina, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Basile
authors.affiliation: Department of Clinical and Experimental Medicine, University Hospital of Messina, A.O.U. Policlinico "G. Martino", Via C. Valeria, 98125, Messina, Italy.
authors.forename: Eleni
authors.initials: E
authors.lastname: Tsiantouli
authors.affiliation: Department of Clinical and Experimental Medicine, University Hospital of Messina, A.O.U. Policlinico "G. Martino", Via C. Valeria, 98125, Messina, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Bellone
authors.affiliation: Department of Human Pathology, University of Messina, Messina, Italy.
authors.forename: Rita Maria
authors.initials: RM
authors.lastname: Agostino
authors.affiliation: Department of Pediatric Sciences, University Hospital of Messina, Messina, Italy.
authors.forename: Basilia
authors.initials: B
authors.lastname: Piraino
authors.affiliation: Department of Pediatric Sciences, University Hospital of Messina, Messina, Italy.
authors.forename: Maria Angela
authors.initials: MA
authors.lastname: La Rosa
authors.affiliation: Department of Pediatric Sciences, University Hospital of Messina, Messina, Italy.
authors.forename: Carmelo
authors.initials: C
authors.lastname: Salpietro
authors.affiliation: Department of Clinical and Experimental Medicine, University Hospital of Messina, A.O.U. Policlinico "G. Martino", Via C. Valeria, 98125, Messina, Italy.
authors.forename: Antonino
authors.initials: A
authors.lastname: Lasco
mesh_terms: D048868:Adaptor Proteins, Signal Transducing; D000328:Adult; D015519:Bone Density / Q000187:drug effects; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D019485:Bone Morphogenetic Proteins / Q000097:blood; D016723:Bone Remodeling / Q000187:drug effects; D005260:Female; D005819:Genetic Markers; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D036341:Intercellular Signaling Peptides and Proteins / Q000097:blood; D010024:Osteoporosis / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D013876:Thiophenes / Q000627:therapeutic use*; D017086:beta-Thalassemia / Q000150:complications*
chemical_list: D048868:Adaptor Proteins, Signal Transducing; D050071:Bone Density Conservation Agents; D019485:Bone Morphogenetic Proteins; C501126:DKK1 protein, human; D005819:Genetic Markers; D036341:Intercellular Signaling Peptides and Proteins; C422903:SOST protein, human; D013876:Thiophenes; C081587:strontium ranelate; D007334:Insulin-Like Growth Factor I
keywords: DKK-1; Osteoporosis; Sclerostin; Strontium ranelate; Thalassemia