School of Pharmacy

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Browsing School of Pharmacy by Author "Dempster, David W."

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    EFFECTS OF BISPHOSPHONATE TREATMENT OF POST-MENOPAUSAL WOMEN ON BONE QUALITY PARAMETERS OF NEWLY FORMED BONE DETERMINED BY RAMAN SPECTROSCOPY. A COMPARISON VS HEALTHY PREMENOPAUSAL WOMEN
    (2023-04-20) Phipps, Roger J.; Gamsjaeger, Sonja; Shane, Elizabeth; Cohen, Adi; Dempster, David W.; Eriksen, Erik F.; Paschalis, Eleftherios P.
    In the treatment of postmenopausal osteoporosis (PMO), the potent bisphosphonates (BPs) alendronate (ALN; Fosamax), risedronate (RIS; Actonel) and zoledronate (ZOL; Reclast) are first line therapy. They produce similar decreases in fracture risk despite different levels of suppression of bone resorption and bone turnover (ALN>ZOL>RIS). To determine if differences in effects on bone quality may play a role in this apparent discrepancy, this study assessed the effects of these BPs on bone quality indices of newly formed trabecular bone. Methods: Iliac crest bone biopsies from PMO patients treated with ALN (for 3 years and ≥ 5 years), RIS (for 3 years and ≥ 5 years), and ZOL (for 6 months, 2 years, ZOL2 and 3 years, ZOL3) were analyzed by Raman microspectroscopy. Bone quality indices mineral to matrix ratio (MM), mineral crystallite maturity/crystallinity (MMC), and glycosaminoglycan (GAG), and pyridinoline (Pyd) content were determined. Biopsies from placebo treated PMO women (PMO-PLC) were also analyzed. Data were compared with those in healthy adult premenopausal women (HC) by ANCOVA followed by post-hoc testing (significance p<0.05). Results: Both RIS groups had MM, MMC and Pyd values similar to HC. ZOL3 had MM and Pyd similar to HC and ZOL2 had MMC similar to HC. Both ALN groups had only MM similar to HC. None of the BP-treated groups had similar GAG to HC. The PLC group had MM similar to HC but was significantly different for MMC, GAG and Pyd. Conclusion: in this analysis PMO patients treated with RIS (Actonel) formed bone with quality closest to that in HC. Those treated with ALN (Fosamax) formed bone with quality least similar to HC. These differences in effects on bone quality may in part explain how these BPs achieve similar antifracture efficacy in treatment of PMO despite differences in bone turnover suppression.