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Effects of long-term alendronate treatment on postmenopausal osteoporosis bone material properties

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Abstract

Summary

Raman microspectroscopic analysis of iliac crest from patients that were treated with alendronate (ALN) for 10 years revealed minimal, transient alterations in bone material properties confined to actively forming bone surfaces compared to patients that were on ALN for 5 years. These changes were not encountered in the bulk tissue.

Introduction

Alendronate (ALN) and other bisphosphonates (BPs) are the most widely prescribed therapy for postmenopausal osteoporosis. Despite their overall excellent safety record and efficacy in reducing fractures, questions have been raised regarding potential detrimental effects that may be related to prolonged bone turnover reduction, although no definite cause-effect relationship has been established to date. The purpose of the present study was to evaluate bone material properties in patients that were receiving ALN for 5 or 10 years.

Methods

Raman microspectroscopic analysis was used to analyze iliac crest biopsies from postmenopausal women with osteoporosis who had been treated with ALN for 5 years and were then re-randomized to placebo (PBO, N = 14), 5 mg/day ALN (N = 10), or 10 mg/day ALN (N = 6) for another 5 years. The parameters monitored and expressed as a function of tissue age were (i) the mineral/matrix ratio (MM), (ii) the relative proteoglycan content (PG), (iii) the relative lipid content (LPD), (iv) the mineral maturity/crystallinity (MMC), and (v) the relative pyridinoline content (PYD).

Results

The obtained data indicate that 10-year ALN use results in minimal, transient bone tissue composition changes compared to use for 5 years, confined to actively forming trabecular surfaces, implying potential differences in bone matrix maturation that nevertheless did not result in differences of these values in bulk tissue.

Conclusions

The data suggest that prolonged reduction in bone turnover during 10 years of therapy with ALN by itself is unlikely to be associated with adverse effects on bone material properties.

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Acknowledgments

The authors would like to thank Merck for provision of the biopsies analyzed. This study was supported by the AUVA (research funds of the Austrian Workers’ Compensation Board) and the WGKK (Viennese Sickness Insurance Funds).

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Authors and Affiliations

  1. Ludwig Boltzmann Institute of Osteology at the Hanusch Hospital of WGKK and AUVA Trauma CentreMeidling, 1st Medical Department, Hanusch Hospital, Heinrich Collin Str. 30, A-1140, Vienna, Austria

    N. Hassler, S. Gamsjaeger, B. Hofstetter, W. Brozek, K. Klaushofer & E. P. Paschalis

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  1. N. Hassler
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  2. S. Gamsjaeger
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Correspondence to E. P. Paschalis.

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Hassler, N., Gamsjaeger, S., Hofstetter, B. et al. Effects of long-term alendronate treatment on postmenopausal osteoporosis bone material properties. Osteoporos Int 26, 339–352 (2015). https://doi.org/10.1007/s00198-014-2929-5

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