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Bone resorption markers indicate early response to osteoporosis therapy

מתוך medicontext.co.il

By Jill Stein

PHOENIX, AZ (Reuters Health) – New findings suggest that assessment of bone resorption markers during the first 3 to 6 months of osteoporosis treatment may be a useful alternative to the conventional method of evaluating therapeutic response, measurement of bone mineral density after 2 years.

At the 23rd Annual Meeting of the American Society for Bone and Mineral Research, Dr. Richard Eastell of the University of Sheffield in the UK presented the results of a study that measured N-telopeptide and C-telopeptide of type I collagen in urine samples from 2442 women with postmenopausal osteoporosis who had sustained at least one vertebral fracture.

All of the women had been treated with a calcium supplement (and vitamin D, if needed), and they had been randomized to risedronate 5 mg/day or placebo for 3 years.

Decreases in bone turnover measured 3 to 6 months after the start of treatment accounted for approximately 50% of risedronate's 1-year effect against vertebral fractures and about 66% of the vertebral fracture risk reduction associated with the medication over 3 years, the researchers reported.

The results also showed that the relationship between fracture risk and bone resorption rate was not linear and that reduction beyond 60% was associated with no additional decrease in fracture risk. As in prior trials, risedronate was shown to suppress bone resorption by a mean of 50% to 60%.

"This is the first time that we can document a link between decreases in bone resorption markers and reductions in fracture risk," Dr. Eastell told Reuters Health. The findings suggest that measuring bone resorption markers may serve as a useful tool for evaluating response to osteoporosis therapy, he added.

Besides the 1- to 2-year period of uncertainty, Dr. Eastell noted, the standard method of evaluating osteoporosis therapy is limited in that increases in bone mineral density are responsible for only about 20% of the fracture risk reduction seen with current therapies.

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