Background: In postmenopausal women with vertebral compression fractures (VCF), the mechanisms regulating healing processes and an anti-osteoporotic treatment are not completely clarified. The aim of this prospective study was the evaluation of bone turnover markers, bone mineral density and radiographic progression of one or more VCF during assumption of bisphosphonates, denosumab, strontium ranelate or teriparatide.
Methods: Women with recent osteoporotic VCF verified through magnetic resonance were assigned to receive bisphosphonates (BIS group, n=28), denosumab (DMAB=25) or strontium ranelate (SR group n=16) or teriparatide (TPTD group, n=24) following guidelines of Italian regulatory agency. Serum and urinary bone turnover markers and lateral thoraco-lumbar spine X-rays were obtained at 0, 3, 6, 12 months of therapy. Lumbar BMD was measured by DEXA before and 12 months after treatment initiation.
Results: At time 0 serum markers of bone formation alkaline phosphatase (ALP), osteocalcin (OC) and of bone resorption desoxipiridoline (DPD) were around higher level of normality. Between 3rd and 6th month within the consolidation process OC remain high in TPTD group while those in other groups remained significantly lower. In the same period ALP levels decreased in BIS group, unchanged in DMAB and SR groups and increased in TPTD group. DPD remain high in TPTD group; while in all groups were significantly and constantly reduced in 6 month. Serum OPG levels remained unchanged in all antiresorptive groups while reduce in anabolic group. Lumbar BMD increased significantly at 12th month in all groups and in particular in TPTD group. An inconstant progression in VCF on radiograms were detected in first six months with BIS and SR groups.
Conclusions: In recent osteoporotic VCF a different radiographic progression with a divergence between the formation and resorption markers has been revealed under anti-osteoporotic therapies.
Disclosure: The authors declared no competing interests.