Dr Paschalis has received research grants from Procter & Gamble Pharmaceuticals, Eli Lilly & Co., and Osteotech. He has received consultancies from Procter & Gamble Pharmaceuticals, Eli Lilly & Co., Osteotech, and Novartis. Dr Roschger holds consultancies with Procter & Gamble Pharmaceuticals and MSD. Dr Klaushofer holds consultancies with Amgen, Procter & Gamble Pharmaceuticals, MSD, Roche, and Novartis. Dr Recker receives consultancies and speaker fees from Merck & Co., Eli Lilly & Co., Wyeth, Procter & Gamble Pharmaceuticals, Amgen, Roche, GSK, Novartis, and NPS Allelix. Dr Phipps is a full-time employee of Procter & Gamble Pharmaceuticals. All other authors state that they have no conflicts of interest.
Version of Record online: 10 JUL 2006
Copyright © 2006 ASBMR
Journal of Bone and Mineral Research
Volume 21, Issue 10, pages 1581–1590, October 2006
How to Cite
Durchschlag, E., Paschalis, E. P., Zoehrer, R., Roschger, P., Fratzl, P., Recker, R., Phipps, R. and Klaushofer, K. (2006), Bone Material Properties in Trabecular Bone From Human Iliac Crest Biopsies After 3- and 5-Year Treatment With Risedronate. J Bone Miner Res, 21: 1581–1590. doi: 10.1359/jbmr.060701
Published online on July 10, 2006;
- Issue online: 4 DEC 2009
- Version of Record online: 10 JUL 2006
- Manuscript Accepted: 3 JUL 2006
- Manuscript Revised: 8 JUN 2006
- Manuscript Received: 6 MAR 2006
- long-term risedronate treatment;
- postmenopausal osteoporosis;
- Fourier transform infrared imaging;
- mineral maturity/crystallinity;
- collagen cross-links
Long-term effects of risedronate on bone mineral maturity/crystallinity and collagen cross-link ratio in triple iliac crest biopsies of osteoporotic women were evaluated. In this double-blinded study, 3- and 5-year treatment with risedronate arrested the tissue aging encountered in untreated osteoporosis and in osteoporosis treated with other antiresorptives. This effect may be contributing to risedronate's antifracture efficacy.
Introduction: Risedronate is widely used in the treatment of osteoporosis. It reduces bone turnover, increases BMD, and decreases fracture risk. To date, there are no data available on the long-term effects of risedronate on bone material properties in humans.
Materials and Methods: Osteoporotic women enrolled in the VERT-NA trial received either risedronate (5 mg/day, orally) or placebo for up to 5 years. All subjects received calcium. They also received vitamin D supplementation if deficient at baseline. Triple iliac crest biopsies were collected from a subset of these subjects at baseline, 3 years, and 5 years. Mineral maturity/crystallinity and collagen cross-link ratio was measured in these biopsies using Fourier transform infrared imaging.
Results: Patients that received placebo exhibited increased mineral maturity/crystallinity and collagen cross-link ratio after 3 and 5 years compared with baseline values. On the contrary, patients that received risedronate retained baseline values in both bone material indices throughout. A more spatially detailed analysis revealed that this was achieved mainly through beneficial effects on active bone-forming areas. Surprisingly, patients that received risedronate achieved premenopausal values at bone-forming areas in both indices after 5 years of treatment.
Conclusion: Long-term treatment with risedronate affects bone material properties (mineral maturity/crystallinity and collagen cross-link ratio) and arrests the tissue aging apparent in untreated osteoporosis. These changes at the material level of the bone matrix may contribute to risedronate's rapid and sustained antifracture efficacy in osteoporotic patients.