Endocrine Abstracts (2009) 20 P244

Effect of one year treatment with strontium ranelate on bone mineral density in women with established osteoporosis previously treated with teriparatide

Athanasios Anastasilakis1, Stergios Polyzos2, Avraam Avramidis2, Athanasios Papatheodorou3 & Evagellos Terpos3


1424 Military Hospital, Thessaloniki, Greece; 2Hippokration General Hospital, Thessaloniki, Greece; 3251 General Air Force Hospital, Athens, Greece.


Teriparatide (TPTD – recombinant human parathyroid hormone 1–34) markedly increases bone mineral density (BMD) and reduces fracture risk. Sequential treatment with an antiresorptive agent is believed to preserve or further increase BMD. Strontium ranelate (SR) is thought to uncouple bone remodeling resulting in increased BMD and reduced fracture risk. In this prospective study, we aimed to evaluate the effect of SR on BMD in women with established osteoporosis previously treated with TPTD. Nineteen postmenopausal Caucasian women (aged 65.9±1.8 years) with established osteoporosis previously treated with TPTD, 20 μg daily for 18 months, sequentially received SR 2 g daily for 12 months. Lumbar spine BMD was measured by dual-energy X-ray absorptiometry (DXA) pre- and post-TPTD administration, as well as twelve months post-SR administration. Blood samples for bone-specific alkaline phosphatase (BSAP) and C-terminal telopeptide of type 1 collagen (CTx) were obtained at the same time points. Lumbar spine BMD increased significantly after 18 months of TPTD (P<0.001) and further improved with sequential SR treatment (P=0.033). Serum BSAP and CTx increased significantly with TPTD (P=0.008 and 0.017, respectively) and reduced to baseline levels after SR treatment (P=0.031 and 0.019, respectively). The change in BSAP was positively correlated with the change in CTx during both TPTD (r=0.641, P=0.007) and SR treatment (r=0.539, P=0.026). In conclusion, our data suggest that SR following TPTD administration further increases BMD and could be used as an alternative to bisphosphonates’ sequential treatment.

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