This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: [10.1002/jbmr.2074]
Bone histomorphometry of transiliac paired bone biopsies after 6 or 12 months of treatment with oral strontium ranelate in 387 osteoporotic women. Randomized comparison to alendronate
© 2013 American Society for Bone and Mineral Research
Disclosure: PC, JPR, NPM and MP have no conflict of interest. Over the last 3 years, PJM has received consulting fees and honoraria for conferences from Servier and RC has received consulting fees and/or research grants and/or honoraria for conferences from Servier, Lilly, Amgen, Merck, Chugai, Roche, Novartis, UCB, Pfizer.
- Accepted manuscript online: 19 AUG 2013 08:02AM EST
- Manuscript Accepted: 13 AUG 2013
- Manuscript Revised: 9 AUG 2013
- Manuscript Received: 12 APR 2013
- Cited By
- Strontium ranelate;
- paired biopsy;
Preclinical studies indicate that strontium ranelate (SrRan) induces opposite effects on bone osteoblasts and osteoclasts, suggesting that SrRan may have a dual action on both formation and resorption. By contrast, alendronate (ALN) is a potent antiresorptive agent. In this multicenter, international, double-blind, controlled study, conducted in 387 postmenopausal women with osteoporosis, transiliac bone biopsies were performed at baseline and after 6 or 12 months of treatment with either SrRan 2 g per day (n = 256) or alendronate 70 mg per week (n = 131). No deleterious effect on mineralization of SrRan or ALN was observed. In the intention-to-treat (ITT) population (268 patients with paired biopsy specimens), changes in static and dynamic bone formation parameters were always significantly higher with ALN compared to SrRan at M6 and M12. Static parameters of formation were maintained between baseline and the last value with SrRan, except for Ob.S/BS, which decreased at M6. Significant decreases in the dynamic parameters of formation (MS/BS, BFR/BS, Aj.AR, Ac.f) were noted at M6 and M12 in SrRan. Compared with ALN, the bone formation parameters at M6 and M12 were always significantly higher (p < 0.001) with SrRan. ALN, but not SrRan, decreased resorption parameters. Compared to the baseline paired biopsy specimens, W.Th was significantly decreased at M6 but not at M12 and cancellous bone structure parameters (BV/TV, Tb.Th, Tb.N, Nd.N/TV) were significantly decreased at M12 with SrRan; none of these changes was significantly different from ALN. In conclusion, this large controlled paired-biopsy study over one year shows that the bone formation remains higher with a lower diminution of the bone remodeling with SrRan versus ALN. From these results SrRan did not show a significant anabolic action on bone remodeling.