Strontium ranelate effect in postmenopausal women with different clinical levels of osteoarthritis
Strontium ranelate effect in postmenopausal women with different clinical levels of osteoarthritis
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DOI：
10.3109/13697137.2010.507887
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发表时间：
2011-04-01
期刊：
影响因子：
2.8
通讯作者：
Christiansen, C.
中科院分区：
文献类型：
--
作者：
Alexandersen, P.;Karsdal, M. A.;Christiansen, C.
方法综合分析了2617名患有骨质疏松症的绝经后妇女(75岁)，随机服用雷奈酸锶或安慰剂，疗程为36个月。软骨降解使用经确认的尿标志物(CTX-II/cr)来评估，而骨吸收则通过血清CTX-I来评估。结果有骨关节炎病史的受试者(OA++)与无骨性关节炎病史的受试者(OA++)相比，其EURO积分CTX-II显著升高(p<；0.0001)，而CTX-I不受骨关节炎状态的影响。在12个月的时间里，无论骨性关节炎的状态如何，雷奈酸锶导致CTX-II的水平较基线显著下降。接受雷奈酸锶治疗的患者在12个月内与安慰剂组相比，CTX-II显著降低(P<；0.001)。结论综合3年来的CTX-II变化可以反映雷尼酸锶对软骨退化的疗效，对早期或轻度临床骨性关节炎的受试者有更大的益处，可能在疾病的早期阶段发挥其软骨保护作用。在早期骨关节炎的目标人群中进行的仔细对照研究是有必要的，以评估雷奈酸锶阻止骨关节炎进展的作用。
Methods aEuro integral The analysis included the 2617 postmenopausal women (75 years old) with osteoporosis randomized to strontium ranelate or placebo for a 36-month period. Cartilage degradation was evaluated using a validated urinary marker adjusted for creatinine (CTX-II/cr), whereas bone resorption was assessed by serum CTX-I. The presence of osteoarthritis was determined by individual interviews.Results aEuro integral CTX-II was significantly elevated at baseline in subjects with a history of osteoarthritis (OA++) compared to subjects who did not (OA--) (p < 0.0001), whereas CTX-I was unaffected by osteoarthritis status. Strontium ranelate caused a significant decrease from baseline in CTX-II over a 12-month period whatever the osteoarthritis status. Strontium ranelate-treated patients had a significant decrease in CTX-II compared to placebo in both OA++ and OA-- groups up to 12 months, the difference remaining still significant at 36 months in patients from the OA-- group (p < 0.001).Conclusions aEuro integral The CTX-II profile of changes over 3 years may reflect efficacy of strontium ranelate against cartilage degradation, with an enhanced beneficial effect in subjects with early or mild clinical osteoarthritis, probably exerting its putative chondroprotective influence in early stages of the disease. Carefully controlled studies in targeted populations with early osteoarthritis are warranted to assess the role of strontium ranelate halting osteoarthritis progression.