1
|
Vergara-Hernandez FB, Nielsen BD, Popovich JM, Panek CL, Logan AA, Robison CI, Ehrhardt RA, Johnson TN, Chargo NJ, Welsh TH, Bradbery AN, Leatherwood JL, Colbath AC. Clodronate disodium does not produce measurable effects on bone metabolism in an exercising, juvenile, large animal model. PLoS One 2024; 19:e0300360. [PMID: 38626145 PMCID: PMC11020481 DOI: 10.1371/journal.pone.0300360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 02/23/2024] [Indexed: 04/18/2024] Open
Abstract
Bisphosphonates are commonly used to treat and prevent bone loss, but their effects in active, juvenile populations are unknown. This study examined the effects of intramuscular clodronate disodium (CLO) on bone turnover, serum bone biomarkers (SBB), bone mineral density (BMD), bone microstructure, biomechanical testing (BT), and cartilage glycosaminoglycan content (GAG) over 165 days. Forty juvenile sheep (253 ± 6 days of age) were divided into four groups: Control (saline), T0 (0.6 mg/kg CLO on day 0), T84 (0.6 mg/kg CLO on day 84), and T0+84 (0.6 mg/kg CLO on days 0 and 84). Sheep were exercised 4 days/week and underwent physical and lameness examinations every 14 days. Blood samples were collected for SBB every 28 days. Microstructure and BMD were calculated from tuber coxae (TC) biopsies (days 84 and 165) and bone healing was assessed by examining the prior biopsy site. BT and GAG were evaluated postmortem. Data, except lameness data, were analyzed using a mixed-effects model; lameness data were analyzed as ordinal data using a cumulative logistic model. CLO did not have any measurable effects on the skeleton of sheep. SBB showed changes over time (p ≤ 0.03), with increases in bone formation and decreases in some bone resorption markers. TC biopsies showed increasing bone volume fraction, trabecular spacing and thickness, and reduced trabecular number on day 165 versus day 84 (p ≤ 0.04). These changes may be attributed to exercise or growth. The absence of a treatment effect may be explained by the lower CLO dose used in large animals compared to humans. Further research is needed to examine whether low doses of bisphosphonates may be used in active juvenile populations for analgesia without evidence of bone changes.
Collapse
Affiliation(s)
- Fernando B. Vergara-Hernandez
- Department of Animal Science, College of Agricultural and Natural Resources, Michigan State University, East Lansing, Michigan, United States of America
- School of Veterinary Medicine, College of Natural Resources and Veterinary Medicine, Universidad Santo Tomas, Viña del Mar, Chile
| | - Brian D. Nielsen
- Department of Animal Science, College of Agricultural and Natural Resources, Michigan State University, East Lansing, Michigan, United States of America
| | - John M. Popovich
- Center for Neuromusculoskeletal Clinical Research, College of Osteopathic Medicine, Michigan State University, East Lansing, Michigan, United States of America
| | - Char L. Panek
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, United States of America
| | - Alyssa A. Logan
- School of Agriculture, College of Basic and Applied Sciences, Middle Tennessee State University, Murfreesboro, Tennessee, United States of America
| | - Cara I. Robison
- Department of Animal Science, College of Agricultural and Natural Resources, Michigan State University, East Lansing, Michigan, United States of America
| | - Richard A. Ehrhardt
- Department of Animal Science, College of Agricultural and Natural Resources, Michigan State University, East Lansing, Michigan, United States of America
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, United States of America
| | - Tyler N. Johnson
- Department of Chemical Engineering and Materials Science, College of Engineering, Michigan State University, East Lansing, Michigan, United States of America
| | - Nicholas J. Chargo
- Department of Physiology, College of Natural Science, Michigan State University, East Lansing, Michigan, United States of America
| | - Thomas H. Welsh
- Department of Animal Science, College of Agriculture & Life Sciences, Texas A&M University, College Station, Texas, United States of America
| | - Amanda N. Bradbery
- Department of Animal and Range Sciences, College of Agriculture, Montana State University, Bozeman, Montana, United States of America
| | - Jessica L. Leatherwood
- Department of Animal Science, College of Agriculture and Natural Resources, Tarleton State University, Stephenville, Texas, United States of America
| | - Aimee C. Colbath
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, United States of America
| |
Collapse
|
2
|
Cooper DML, Harrison KD, Hiebert BD, King GA, Panahifar A, Zhu N, Swekla KJ, Pivonka P, Chapman LD, Arnason T. Daily administration of parathyroid hormone slows the progression of basic multicellular units in the cortical bone of the rabbit distal tibia. Bone 2023; 176:116864. [PMID: 37574096 DOI: 10.1016/j.bone.2023.116864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 07/19/2023] [Accepted: 08/01/2023] [Indexed: 08/15/2023]
Abstract
Basic Multicellular Units (BMUs) conduct bone remodeling, a critical process of tissue turnover which, if imbalanced, can lead to disease, including osteoporosis. Parathyroid hormone (PTH 1-34; Teriparatide) is an osteoanabolic treatment for osteoporosis; however, it elevates the rate of intra-cortical remodeling (activation frequency) leading, at least transiently, to increased porosity. The purpose of this study was to test the hypothesis that PTH not only increases the rate at which cortical BMUs are initiated but also increases their progression (Longitudinal Erosion Rate; LER). Two groups (n = 7 each) of six-month old female New Zealand white rabbits were both administered 30 μg/kg of PTH once daily for a period of two weeks to induce remodeling. Their distal right tibiae were then imaged in vivo by in-line phase contrast micro-CT at the Canadian Light Source synchrotron. Over the following two weeks the first group (PTH) received continued daily PTH while the second withdrawal group (PTHW) was administrated 0.9 % saline. At four weeks all animals were euthanized, their distal tibiae were imaged by conventional micro-CT ex vivo and histomorphometry was performed. Matching micro-CT datasets (in vivo and ex vivo) were co-registered in 3D and LER was measured from 612 BMUs. Counter to our hypothesis, mean LER was lower (p < 0.001) in the PTH group (30.19 ± 3.01 μm/day) versus the PTHW group (37.20 ± 2.77 μm/day). Despite the difference in LER, osteonal mineral apposition rate (On.MAR) did not differ between groups indicating the anabolic effect of PTH was sustained after withdrawal. The slowing of BMU progression by PTH warrants further investigation; slowed resorption combined with elevated bone formation rate, may play an important role in how PTH enhances coupling between resorption and formation within the BMU. Finally, the prolonged anabolic response following withdrawal may have utility in terms of optimizing clinical dosing regimens.
Collapse
Affiliation(s)
- David M L Cooper
- Department of Anatomy, Physiology and Pharmacology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
| | - Kim D Harrison
- Department of Anatomy, Physiology and Pharmacology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Beverly D Hiebert
- Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Gavin A King
- Department of Anatomy, Physiology and Pharmacology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Arash Panahifar
- BioMedical Imaging and Therapy Beamline, Canadian Light Source, Saskatoon, Saskatchewan, Canada; Department of Medical Imaging, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Ning Zhu
- BioMedical Imaging and Therapy Beamline, Canadian Light Source, Saskatoon, Saskatchewan, Canada
| | - Kurtis J Swekla
- Animal Care and Research Support Office, Office of the Vice-President of Research, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Peter Pivonka
- School of Mechanical, Medical, and Process Engineering, Queensland University of Technology, Brisbane, Australia
| | - L Dean Chapman
- Department of Anatomy, Physiology and Pharmacology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Terra Arnason
- Department of Medicine, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| |
Collapse
|
3
|
Accumulation of zoledronic acid in rabbit intervertebral discs. J Chromatogr B Analyt Technol Biomed Life Sci 2022; 1197:123229. [DOI: 10.1016/j.jchromb.2022.123229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 03/01/2022] [Accepted: 03/15/2022] [Indexed: 11/19/2022]
|
4
|
Hughes-Austin JM, Dwight KD, Ginsberg C, Tipps A, Salusky IB, Pereira RC, Ix JH. Regional variation in bone turnover at the iliac crest versus the greater trochanter. Bone 2021; 143:115604. [PMID: 32827849 PMCID: PMC7769907 DOI: 10.1016/j.bone.2020.115604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 07/20/2020] [Accepted: 08/16/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Iliac crest bone biopsy with histomorphometry is the gold standard for diagnosis of abnormalities in bone turnover, yet fractures more frequently occur at the greater trochanter of the hip. Whether bone turnover is similar at these two anatomic sites within individuals is uncertain. METHODS We collected bone biopsy samples from the ipsilateral iliac crest and greater trochanter in 9 deceased individuals undergoing autopsies at an academic medical center between March-August 2018. We measured 14 static bone histomorphometry parameters including osteoclast number (N.Oc/T.A), eroded surface (ES/BS), trabecular separation (Tb.Sp), osteoclast surface (Oc.S/BS) and osteoid volume (OV/BV) as markers of bone turnover, mineralization, and volume (TMV), and evaluated the correlation of these markers between the iliac crest and greater trochanter. RESULTS Average age at time of death was 58 ± 15 years, 2 were women, and average time from death to autopsy was 2.9 ± 1.8 days. Overall, correlations of the markers of bone turnover across the two sites were poor, ranging from as low as 0 for Tb.Sp (p = 1.0) to as high as 0.583 for Oc.S/BS (p = 0.102). CONCLUSIONS Static histomorphometric measures of bone turnover at the iliac crest may not provide reliable information about turnover at other anatomic sites.
Collapse
Affiliation(s)
- Jan M Hughes-Austin
- Department of Orthopaedic Surgery, University of California San Diego, La Jolla, CA, USA.
| | - Kathryn D Dwight
- Department of Orthopaedic Surgery, University of California San Diego, La Jolla, CA, USA
| | - Charles Ginsberg
- Division of Nephrology-Hypertension, Department of Medicine, University of California, San Diego, La Jolla, CA, USA; Nephrology Section, Veterans Affairs of San Diego, San Diego, CA, USA
| | - Ann Tipps
- Department of Pathology, University of California, San Diego, La Jolla, CA, USA
| | - Isidro B Salusky
- Department of Pediatrics, University of California Los Angeles, Los Angeles, CA, USA
| | - Renata C Pereira
- Department of Pediatrics, University of California Los Angeles, Los Angeles, CA, USA
| | - Joachim H Ix
- Division of Nephrology-Hypertension, Department of Medicine, University of California, San Diego, La Jolla, CA, USA; Nephrology Section, Veterans Affairs of San Diego, San Diego, CA, USA
| |
Collapse
|
5
|
Coutel X, Falgayrac G, Penel G, Olejnik C. Short-term high-dose zoledronic acid enhances crystallinity in mandibular alveolar bone in rats. Eur J Oral Sci 2020; 128:284-291. [PMID: 32430956 DOI: 10.1111/eos.12702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2020] [Indexed: 11/29/2022]
Abstract
Owing to its antiresorptive properties, zoledronic acid (ZOL) is commonly used in the management of benign as well as malignant bone diseases. This molecule targets sites where bone is actively remodeling, and high concentrations have been reported in the jaw. The purpose of this study was to investigate whether treatment of male rats with ZOL, at a dosage equivalent to that used for antitumor treatment, impacts the short-term qualitative properties of mandibular bone independent of bone remodeling. Thirty rats were randomly assigned to treatment either with ZOL or with serum-vehicle (control) (weekly injections: 100 μg kg-1 for 6 wk, n = 15 per group). Using the tetracycline double-labeling technique, remodeled bone areas, corresponding to the preferential site of bisphosphonate binding, were found in the alveolar bone along the alveolar bone proper. The composition of bone in these areas was characterized using Raman microspectroscopy and compared with adjacent, non-remodeled, older bone. The ZOL-treated group exhibited higher crystallinity in the remodeled bone areas (+2%), reflecting an early maturation of the apatite mineral after ZOL injection. Our findings highlight a direct and rapid effect of clinically relevant anti-tumoral ZOL doses on the qualitative properties of mandibular bone, especially on mineral crystallinity in the vicinity of the teeth, namely, the alveolar bone proper.
Collapse
Affiliation(s)
- Xavier Coutel
- Univ. Lille, Univ. Littoral Côte d'Opale, CHU Lille, ULR 4490 - MABLab - Marrow Adiposity and Bone Lab,, F-59000 Lille, France
| | - Guillaume Falgayrac
- Univ. Lille, Univ. Littoral Côte d'Opale, CHU Lille, ULR 4490 - MABLab - Marrow Adiposity and Bone Lab,, F-59000 Lille, France
| | - Guillaume Penel
- Univ. Lille, Univ. Littoral Côte d'Opale, CHU Lille, ULR 4490 - MABLab - Marrow Adiposity and Bone Lab,, F-59000 Lille, France
| | - Cécile Olejnik
- Univ. Lille, Univ. Littoral Côte d'Opale, CHU Lille, ULR 4490 - MABLab - Marrow Adiposity and Bone Lab,, F-59000 Lille, France
| |
Collapse
|
6
|
Qiu S, Divine GW, Palnitkar S, Kulkarni P, Guthrie TS, Honasoge M, Rao SD. Bone Structure and Turnover Status in Postmenopausal Women with Atypical Femur Fracture After Prolonged Bisphosphonate Therapy. Calcif Tissue Int 2017; 100:235-243. [PMID: 28013363 PMCID: PMC5315598 DOI: 10.1007/s00223-016-0223-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2016] [Accepted: 12/16/2016] [Indexed: 12/31/2022]
Abstract
Atypical femur fracture (AFF), a serious complication of long-term bisphosphonate therapy, is usually preceded by an incomplete fracture appearing on the lateral femur. AFF is most likely the result of severely suppressed bone turnover (SSBT). However, the differences in bone structure and turnover between patients with incomplete and complete AFF remain unknown. We examined trans-iliac bone biopsies from 12 white postmenopausal women with AFF (incomplete = 5; complete = 7) on BP therapy of >5 years and 43 healthy white premenopausal women. Histomorphometric measurements were performed separately in cancellous, intracortical and endosteal envelopes. Of the 43 histomorphometric measurements on 3 difference bone surfaces (cancellous, intracortical and endosteal), only 2 bone resorption variables (Oc.S/BS and Oc.S/NOS) on the endosteal surface were significantly lower in patients with complete AFF than those with incomplete AFF. Compared to healthy premenopausal women, the trabecular bone volume, thickness and number were all significantly lower in patients with AFF. The dynamic bone formation variables in patients with AFF were significantly reduced on all bone surfaces. The likelihood of a biopsy with no tetracycline labeling was significantly higher in AFF patients than in healthy premenopausal women. Based on these results, we conclude that there are no significant differences in bone turnover between patients with incomplete and complete AFF, suggesting that the suppression of bone turnover had already existed in the femur with incomplete AFF. Compared to healthy premenopausal women, bone turnover is similarly suppressed in patients with either type of AFF.
Collapse
Affiliation(s)
- Shijing Qiu
- Bone and Mineral Research Laboratory, Henry Ford Hospital, Detroit, MI, USA.
| | - George W Divine
- Department of Public Health Sciences, Henry Ford Hospital, Detroit, MI, USA
| | - Saroj Palnitkar
- Bone and Mineral Research Laboratory, Henry Ford Hospital, Detroit, MI, USA
| | - Pooja Kulkarni
- Bone and Mineral Research Laboratory, Henry Ford Hospital, Detroit, MI, USA
| | - Trent S Guthrie
- Department of Orthopedic Surgery, Henry Ford Hospital, Detroit, MI, USA
| | - Mahalakshmi Honasoge
- Division of Endocrinology, Diabetes, and Bone and Mineral Disorders, Henry Ford Hospital, Detroit, MI, USA
| | - Sudhaker D Rao
- Bone and Mineral Research Laboratory, Henry Ford Hospital, Detroit, MI, USA
- Division of Endocrinology, Diabetes, and Bone and Mineral Disorders, Henry Ford Hospital, Detroit, MI, USA
| |
Collapse
|
7
|
Ocaña RP, Rabelo GD, Sassi LM, Rodrigues VP, Alves FA. Implant osseointegration in irradiated bone: an experimental study. J Periodontal Res 2016; 52:505-511. [PMID: 27624290 DOI: 10.1111/jre.12416] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVES The aim of this study was to evaluate the effect of radiotherapy on the osseointegration of dental implants in the tibia and the action of platelet-rich plasma (PRP) as an adjuvant therapy. MATERIAL AND METHODS A total of 18 rabbits received two implants in each tibial epiphysis, totalizing 72 implants. The control group (group I) was composed by six rabbits and did not receive radiotherapy. The test groups (II and III) received a single dose of 1727 cGy. Group II was composed by six irradiated animals and group III by six animals that received irradiation and PRP during implant placement. The implant success rate, the bone-implant contact (BIC), and the bone volume were analyzed. RESULTS There was no osseointegration in four of the implants, three in group II and one in group III. Total BIC was significantly higher in group I, when compared to the other groups. There was a significant difference of osteoid BIC only between irradiated animals (group II, 8.5%; group III, 4.7%; p = 0.001). On the other hand, the mineralized BIC was significantly higher in group I. Furthermore, group II had a lower mineralized BIC than group III (p = 0.002). Bone volume was higher in the control group (41.3%), followed by group III (33.4%) and II (25.1%), with differences between groups I and II (p = 0.001) and groups II and III (p = 0.022). CONCLUSIONS The present study showed that both the bone volume and BIC were higher in the control group. However, the failure rates of the implants were low in both irradiated groups. The PRP was a positive adjuvant in the osseointegration process.
Collapse
Affiliation(s)
- R P Ocaña
- Department of Stomatology, AC Camargo Cancer Center, São Paulo, Brazil
| | - G D Rabelo
- Department of Stomatology, AC Camargo Cancer Center, São Paulo, Brazil
| | - L M Sassi
- Department of Stomatology, Erasto Gaertner Cancer Hospital, Curitiba, Brazil
| | - V P Rodrigues
- Faculty of Dentistry, University of São Paulo, São Paulo, Brazil
| | - F A Alves
- Department of Stomatology, AC Camargo Cancer Center, São Paulo, Brazil.,Department of Stomatology, Faculty of Dentistry, University of São Paulo, São Paulo, Brazil
| |
Collapse
|
8
|
Chavassieux P, Portero-Muzy N, Roux JP, Garnero P, Chapurlat R. Response to the Letter: Are Biochemical Markers of Bone Turnover Representative of Bone Histomorphometry in 370 Postmenopausal Women? J Clin Endocrinol Metab 2016; 101:L26. [PMID: 26840112 DOI: 10.1210/jc.2015-4237] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
|
9
|
Chavassieux P, Portero-Muzy N, Roux JP, Garnero P, Chapurlat R. Are Biochemical Markers of Bone Turnover Representative of Bone Histomorphometry in 370 Postmenopausal Women? J Clin Endocrinol Metab 2015; 100:4662-8. [PMID: 26505821 DOI: 10.1210/jc.2015-2957] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
CONTEXT The levels of bone formation and resorption can be assessed at the tissue level by bone histomorphometry on transiliac bone biopsies. Systemic biochemical markers of bone turnover reflect the overall bone formation and resorption at the level of the entire skeleton but cannot discriminate the different skeletal compartments. OBJECTIVE Our aim was to investigate the correlations between the serum biochemical markers of formation and resorption with histomorphometric parameters. DESIGN We performed post hoc analysis of a previous clinical study. SETTING Patients were selected from the general population. PATIENTS A total of 371 untreated postmenopausal osteoporotic women aged 50 to 84 years with a lumbar T-score ≤ -2.5 SD or ≤ -1 SD with at least one osteoporotic fracture. INTERVENTIONS Transiliac bone biopsies were obtained after a double tetracycline labeling, and blood samples were collected. MAIN OUTCOME MEASURES The static and dynamic parameters of formation and bone resorption were measured by histomorphometry. Serum biochemical markers of formation (bone alkaline phosphatase [ALP]; procollagen type I N-terminal propeptide [PINP]) and resorption (C-terminal crosslinking telopeptide of collagen type 1 [sCTX]) were assessed. RESULTS The mean values of biochemical markers were: bone ALP, 15.0 ± 5.2 ng/mL; PINP, 56.2 ± 21.9 μg/mL; and sCTX, 0.58 ± 0.26 ng/mL. Bone ALP and PINP were significantly correlated with both the static and dynamic parameters of formation (0.21 ≤ r' ≤ 0.36; 0.01 ≥ P ≥ .0001). sCTX was significantly correlated with all resorption parameters (0.18 ≤ r' ≤ 0.24; 0.02 ≥ P ≥ .0001). CONCLUSION Bone turnover markers were significantly but modestly associated with bone turnover parameters measured in iliac cancellous bone. The iliac crest bone may not represent perfectly the whole bone turnover.
Collapse
Affiliation(s)
| | | | - Jean-Paul Roux
- Inserm UMR 1033 and Université de Lyon, 69372 Lyon, France
| | | | | |
Collapse
|
10
|
Colón-Emeric C, Pieper CF, Grubber J, Van Scoyoc L, Schnell ML, Van Houtven CH, Pearson M, Lafleur J, Lyles KW, Adler RA. Correlation of hip fracture with other fracture types: Toward a rational composite hip fracture endpoint. Bone 2015; 81:67-71. [PMID: 26151123 PMCID: PMC4772882 DOI: 10.1016/j.bone.2015.07.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Revised: 06/18/2015] [Accepted: 07/02/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE With ethical requirements to the enrollment of lower risk subjects, osteoporosis trials are underpowered to detect reduction in hip fractures. Different skeletal sites have different levels of fracture risk and response to treatment. We sought to identify fracture sites which cluster with hip fracture at higher than expected frequency; if these sites respond to treatment similarly, then a composite fracture endpoint could provide a better estimate of hip fracture reduction. METHODS Cohort study using Veterans Affairs and Medicare administrative data. Male Veterans (n=5,036,536) aged 50-99 years receiving VA primary care between 1999 and 2009 were included. Fractures were ascertained using ICD9 and CPT codes and classified by skeletal site. Pearson correlation coefficients, logistic regression and kappa statistics were used to describe the correlation between each fracture type and hip fracture within individuals, without regard to the timing of the events. RESULTS 595,579 (11.8%) men suffered 1 or more fractures and 179,597 (3.6%) suffered 2 or more fractures during the time under study. Of those with one or more fractures, the rib was the most common site (29%), followed by spine (22%), hip (21%) and femur (20%). The fracture types most highly correlated with hip fracture were pelvic/acetabular (Pearson correlation coefficient 0.25, p<0.0001), femur (0.15, p<0.0001), and shoulder (0.11, p<0.0001). CONCLUSIONS Pelvic, acetabular, femur, and shoulder fractures cluster with hip fractures within individuals at greater than expected frequency. If we observe similar treatment risk reductions within that cluster, subsequent trials could consider the use of a composite endpoint to better estimate hip fracture risk.
Collapse
Affiliation(s)
- Cathleen Colón-Emeric
- Duke University Center for the Study of Aging and Human Development, Durham, NC, United States; Durham VA Geriatric Research Education and Clinical Center, Durham, NC, United States.
| | - Carl F Pieper
- Duke University Center for the Study of Aging and Human Development, Durham, NC, United States
| | - Janet Grubber
- Durham VA Health Services Research and Development Center, Durham, NC, United States
| | - Lynn Van Scoyoc
- Durham VA Health Services Research and Development Center, Durham, NC, United States
| | - Merritt L Schnell
- Durham VA Health Services Research and Development Center, Durham, NC, United States
| | - Courtney Harold Van Houtven
- Duke University Center for the Study of Aging and Human Development, Durham, NC, United States; Durham VA Health Services Research and Development Center, Durham, NC, United States; Duke University Department of Medicine, Durham, NC, United States
| | - Megan Pearson
- Durham VA Health Services Research and Development Center, Durham, NC, United States
| | | | - Kenneth W Lyles
- Duke University Center for the Study of Aging and Human Development, Durham, NC, United States; Durham VA Geriatric Research Education and Clinical Center, Durham, NC, United States
| | | |
Collapse
|
11
|
Rabelo GD, Travençolo BAN, Oliveira MA, Beletti ME, Gallottini M, Silveira FRXD. Changes in cortical bone channels network and osteocyte organization after the use of zoledronic acid. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2015; 59:507-14. [PMID: 26331228 DOI: 10.1590/2359-3997000000097] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Accepted: 07/06/2015] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the effects of zoledronic acid (ZA) on the cortical bone channels network (CBCN) and osteocyte organization in relation to the bone channels. MATERIALS AND METHODS Eighteen male Wistar rats were divided into control (CG) and test groups (TG). Twelve animals from TG received 3 ZA doses (7.5 µg/kg), and 6 animals from CG did not receive any medication. TG animals were euthanized at 14 (n = 6) and 75 (n = 6) dadys after drug injection. CBCN was analyzed in mandibles and tibias using computational routines. The osteocyte organization was qualitatively evaluated in tibias using a three-dimensional reconstruction of images from serial histological sections. RESULTS Significant differences in CBCN of tibia were found between the treated and untreated rats, with a wider range of sizes and shapes of the channels after the use of ZA (channels area p = 0.0063, channels area SD p = 0.0276) and less bone matrix (bone volume p = 0.0388). The alterations in the channels' morphology were more evident at 75 days after the drug injection (channels perimeter p = 0.0286). No differences were found in mandibles CBCN. The osteocyte distribution revealed more variable patterns of cell distribution in ZA groups, with non-homogeneous distribution of cells in relation to the bone channels. CONCLUSION Zoledronic acid induces structural changes in CBCN and modifies the osteocyte arrangement in cortical bone in the tibia; also, the variability in the morphology of bone channels became more evident after a certain time of the use of the drug.
Collapse
Affiliation(s)
- Gustavo Davi Rabelo
- Departamento de Estomatologia, Faculdade de Odontologia, Universidade de São Paulo, São Paulo, SP, Brazil
| | | | - Marcio Augusto Oliveira
- Departamento de Estomatologia, Faculdade de Odontologia, Universidade de São Paulo, São Paulo, SP, Brazil
| | | | - Marina Gallottini
- Departamento de Estomatologia, Faculdade de Odontologia, Universidade de São Paulo, São Paulo, SP, Brazil
| | | |
Collapse
|
12
|
Chavassieux P, Meunier PJ, Roux JP, Portero-Muzy N, Pierre M, Chapurlat R. Bone histomorphometry of transiliac paired bone biopsies after 6 or 12 months of treatment with oral strontium ranelate in 387 osteoporotic women: randomized comparison to alendronate. J Bone Miner Res 2014; 29:618-28. [PMID: 23959630 DOI: 10.1002/jbmr.2074] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Revised: 08/09/2013] [Accepted: 08/13/2013] [Indexed: 11/09/2022]
Abstract
Preclinical studies indicate that strontium ranelate (SrRan) induces opposite effects on bone osteoblasts and osteoclasts, suggesting that SrRan may have a dual action on both formation and resorption. By contrast, alendronate (ALN) is a potent antiresorptive agent. In this multicenter, international, double-blind, controlled study conducted in 387 postmenopausal women with osteoporosis, transiliac bone biopsies were performed at baseline and after 6 or 12 months of treatment with either SrRan 2 g per day (n = 256) or alendronate 70 mg per week (n = 131). No deleterious effect on mineralization of SrRan or ALN was observed. In the intention-to-treat (ITT) population (268 patients with paired biopsy specimens), changes in static and dynamic bone formation parameters were always significantly higher with ALN compared with SrRan at month 6 (M6) and month 12 (M12). Static parameters of formation were maintained between baseline and the last value with SrRan, except for osteoblast surfaces, which decreased at M6. Significant decreases in the dynamic parameters of formation (mineralizing surface, bone formation rate, adjusted apposition rate, activation frequency) were noted at M6 and M12 in SrRan. Compared with ALN, the bone formation parameters at M6 and M12 were always significantly higher (p < 0.001) with SrRan. ALN, but not SrRan, decreased resorption parameters. Compared with the baseline paired biopsy specimens, wall thickness was significantly decreased at M6 but not at M12 and cancellous bone structure parameters (trabecular bone volume, trabecular thickness, trabecular number, number of nodes/tissue volume) were significantly decreased at M12 with SrRan; none of these changes were significantly different from ALN. In conclusion, this large controlled paired biopsy study over 1 year shows that the bone formation remains higher with a lower diminution of the bone remodeling with SrRan versus ALN. From these results, SrRan did not show a significant anabolic action on bone remodeling.
Collapse
|
13
|
Bibliography Current World Literature. CURRENT ORTHOPAEDIC PRACTICE 2013. [DOI: 10.1097/bco.0b013e31829684d2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|