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Bone turnover and bone collagen maturation in osteoporosis: effects of antiresorptive therapies.

Author(s): Byrjalsen I, Leeming DJ, Qvist P, Christiansen C, Karsdal MA

Affiliation(s): Nordic Bioscience A/S, Herlev Hovedgade 207, Herlev DK-2730, Denmark. ib@nordicbioscience.com

Publication date & source: 2008-03, Osteoporos Int., 19(3):339-48. Epub 2007 Sep 11.

Publication type: Randomized Controlled Trial

SUMMARY: Bone collagen maturation may be important for anti-fracture efficacy as the reduction in risk is only partly explained by a concomitant increase in BMD during anti-resorptive therapy. Different treatments caused diverse profiles in bone collagen degradation products, which may have implications for bone quality. INTRODUCTION: The aim of the present study was to evaluate the effect of different anti-resorptive treatments on bone collagen maturation measured as the ratio between the degradation products of newly synthesized and mature isomerized C-telopeptides of type I collagen. METHODS: Participants were from cohorts of healthy postmenopausal women participating in double blind, placebo-controlled 2-year studies of alendronate, ibandronate, intranasal hormone replacement therapy (HRT), oral HRT, transdermal HRT, or raloxifene (n = 427). The non-isomerized alphaalphaCTX and isomerized betabetaCTX were measured in urine samples obtained at baseline, and after 6, 12, and 24 months of therapy. RESULTS: Bone collagen maturation measured as the ratio between alphaalphaCTX and betabetaCTX showed that bisphosphonate treatment induced a collagen profile consistent with an older matrix with a 52% (alendronate) and 38% (ibandronate) reduction in the ratio between the two CTX isoforms vs. 3% and 15% with HRT or raloxifene, respectively. CONCLUSIONS: Anti-resorptive treatments had different effects on the endogenous profile of bone collagen maturation. Whether that effect on bone collagen has an impact on bone strength independent on the treatment-dependent effect on BMD should be investigated.

Page last updated: 2008-08-11

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