Comparative Effects of Teriparatide and Strontium Ranelate on Bone Biopsies and Biochemical Markers of Bone Turnover in Postmenopausal Women With Osteoporosis
Comparative Effects of Teriparatide and Strontium Ranelate on Bone Biopsies and Biochemical Markers of Bone Turnover in Postmenopausal Women With Osteoporosis
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DOI：
10.1359/jbmr.090315
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发表时间：
2009-08-01
影响因子：
6.2
通讯作者：
Stepan, Jan
中科院分区：
文献类型：
--
作者：
Recker, Robert R.;Marin, Fernando;Stepan, Jan
我们评估了绝经后骨质疏松症妇女每日皮下注射特立哌酮（n = 39，20 μ g/d）或口服雷奈酸锶（SrR，n = 40，2 g/d）后对骨重建和组织形态计量学的影响。治疗6个月后，从特立帕肽组的29名患者和SrR组的22名患者中获得了可评价的活检。平均+/- SD矿化表面占骨表面的百分比小梁水平的MS/BS（%）为7.73 +/- 1.48%（特立哌隆）和5.25 +/- 1.15%（SrR）（p = 0.219）和皮质内水平分别为17.22 +/- 3.06%和9.70 +/-2.07%（p = 0.052）。皮质骨孔隙率在teriparterine组为5.40 +/- 0.41%，在SrR组为4.14 +/- 0.40%（p = 0.037）。特立帕鲁肽诱导骨形成和骨吸收标志物较基线显著增加，1个月后I型胶原氨基末端前肽（PINP）达到统计学显著性（+57%，p < 0.001）。SrR诱导PINP在3个月（-14%，p = 0.005）和6个月（-19%，p < 0.001）时较基线降低，血清I型胶原蛋白（β-CTX）在1个月和3个月（-11%，p < 0.05）时较基线降低，但具有统计学显著性。SrR治疗后发生不良事件的患者（70%）多于特立帕鲁肽治疗后发生不良事件的患者（41%）（p = 0.013）。总之，骨形成的生化标志物的变化证实了特立哌酮的骨形成活性，而不是SrR治疗。SrR对骨重塑和细胞活性的影响是适度的，表明其对骨折复位的影响可能主要是通过与合成代谢或更有效的抗吸收剂观察到的不同机制介导的。骨矿研究杂志2009;24：1358-1368。2009年3月30日在线发布; doi：10.1359/JBMR.090315
We assessed the effects on bone remodeling and histomorphometry after daily subcutaneous injections of teriparatide (n = 39, 20 mu g/d) or oral strontium ranelate (SrR, n = 40, 2 g/d) in postmenopausal women with osteoporosis. Evaluable biopsies were obtained from 29 patients in the teriparatide group and 22 in the SrR group after 6 mo of treatment. The mean +/- SD mineralization surfaces as a percent of bone surfaces (MS/BS, %) at the trabecular level were 7.73 +/- 1.48% for teriparatide and 5.25 +/- 1.15% for SrR (p = 0.219) and at the endocortical level were 17.22 +/- 3.06% and 9.70 +/- 2.07%, respectively (p = 0.052). Cortical porosity was 5.40 +/- 0.41% in the teriparatide and 4.14 +/- 0.40% in the SrR group (p = 0.037). Teriparatide induced significant increases from baseline in bone formation and resorption markers, reaching statistical significance for amino-terminal propeptide of type I collagen (PINP) after 1 mo (+57%, p < 0.001). SrR induced small, but statistically significant, reductions from baseline in PINP at 3 (-14%, p = 0.005) and 6 mo (-19%, p < 0.001) and in serum P-C-terminal telopeptide of type I collagen (beta-CTX) at 1 and 3 mo (-11%, for both,p < 0.05). There were more patients with adverse events after SrR (70%) than teriparatide (41%) treatment (p = 0.013). In conclusion, the changes in biochemical markers of bone formation confirmed bone-forming activity of teriparatide but not of SrR treatment. The effects of SrR on bone remodeling and cell activity were modest, indicating that its effects on fracture reduction may be predominantly mediated through a different mechanism than that observed with anabolic or more potent antiresorptive agents. J Bone Miner Res 2009;24:1358-1368. Published online on March 30, 2009; doi: 10.1359/JBMR.090315