Bone Abstracts

Introduction: In postmenopausal women with vertebral compression fractures (VCF) the mechanisms regulating healing processes and an anti-osteoporotic treatment are not completely clarified. The aim of this prospective study was the evaluation of bone turnover markers, bone mineral density and radiographic progression of one or more VCF during assumption of risedronate, strontium ranelate or teriparatide.

Materials and methods: Women with recent osteoporotic VCF verified through magnetic resonance were assigned to receive either risedronate (RIS group, n=19) or strontium ranelate (SR group n=16) or teriparatide (TPTD group, n=24) following guidelines of Italian regulatory agency. Serum and urinary bone turnover markers and lateral thoraco-lumbar spine X-rays were obtained at 0, 1, 3 and 6 months of therapy. Lumbar BMD was measured by DEXA before and 6 months after treatment initiation.

Results: At time 0 serum markers of bone formation alkaline phosphatase (ALP), osteocalcin (OC) and of bone resorption desoxipiridoline (DPD) but also osteoprotegerin (OPG) were around higher level of normality, while sclerostin (SOST) was substantially unchanged. Between 1st and 3rd month within the consolidation process OC peaked in TPTD group while those in RIS group and SR group remained significantly lower. In the same period ALP levels decreased in RIS group, unchanged in SR group and increased in TPTD group. DPD remain high in TPTD group; while in all groups were significantly and constantly reduced in 6 months. Serum OPG levels remained unchanged in RIS group and SR group while reduce in TPTD group. SOST was significantly increased 6 months in RIS group, whereas remained statistically unaffected in the TPTD group. Lumbar BMD increased significantly at 6 months in all groups and in particular in TPTD group. An inconstant progression in VCF on radiograms were detected in RIS and SR groups.

Conclusions: In recent osteoporotic VCF a divergence between the formation and resorption markers has been revealed between anti-osteoporotic therapies with a different radiographic progression.