Document Detail

Effects of PTH and alendronate on type I collagen isomerization in postmenopausal women with osteoporosis: the PaTH study.
MedLine Citation:
PMID:  18442311     Owner:  NLM     Status:  MEDLINE    
Fracture efficacy of PTH and alendronate (ALN) is only partly explained by changes in BMD, and bone collagen properties have been suggested to play a role. We analyzed the effects of PTH(1-84) and ALN on urinary alphaalpha/betabeta CTX ratio, a marker of type I collagen isomerization and maturation in postmenopausal women with osteoporosis. In the first year of the previously published PaTH study, postmenopausal women with osteoporosis were assigned to PTH(1-84) (100 microg/d; n = 119), ALN (10 mg/d; n = 60), or PTH and ALN together (n = 59). We analyzed patients on ALN alone (n = 60) and a similar number of patients assigned to PTH alone (n = 63). During the second year, women on PTH in the first year were reallocated to placebo (n = 31) or ALN (n = 32) and women with ALN continued on ALN. During the first year, there was no significant change in alphaalpha/betabeta CTX ratio with PTH or ALN. At 24 mo, there was a marked increase of the alphaalpha/betabeta CTX ratio in women who had received PTH during the first year, followed by a second year of placebo (median: +45.5, p < 0.001) or ALN (+55.2%, p < 0.001). Conversely, the alphaalpha/betabeta CTX ratio only slightly increased (+16%, p < 0.05) after 2 yr of continued ALN. In conclusion, treatment with PTH(1-84) for 1 yr followed by 1 yr of placebo or ALN may be associated with decreased type I collagen isomerization. The influence of these biochemical changes of type I collagen on bone fracture resistance remains to be studied.
Patrick Garnero; Doug C Bauer; Emmanuel Mareau; John P Bilezikian; Susan L Greenspan; Clifford Rosen; Dennis Black
Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research     Volume:  23     ISSN:  1523-4681     ISO Abbreviation:  J. Bone Miner. Res.     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-08-18     Completed Date:  2008-10-28     Revised Date:  2013-06-05    
Medline Journal Info:
Nlm Unique ID:  8610640     Medline TA:  J Bone Miner Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1442-8     Citation Subset:  IM    
INSERM Research Unit 664, Lyon, France
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MeSH Terms
Aged, 80 and over
Alendronate / pharmacology,  therapeutic use*
Biological Markers / metabolism
Bone and Bones / drug effects,  metabolism
Collagen Type I / chemistry*,  urine
Middle Aged
Osteoporosis, Postmenopausal / drug therapy*,  urine
Parathyroid Hormone / pharmacology,  therapeutic use*
Grant Support
Reg. No./Substance:
0/Biological Markers; 0/Collagen Type I; 0/Parathyroid Hormone; 0/Placebos; 66376-36-1/Alendronate

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