PMID- 25990354 OWN - NLM STAT- MEDLINE DCOM- 20161024 LR - 20220408 IS - 1433-2965 (Electronic) IS - 0937-941X (Linking) VI - 27 IP - 1 DP - 2016 Jan TI - Response of bone turnover markers to three oral bisphosphonate therapies in postmenopausal osteoporosis: the TRIO study. PG - 21-31 LID - 10.1007/s00198-015-3145-7 [doi] AB - We used bone turnover markers to identify women who responded to bisphosphonate treatment for osteoporosis. Response was more likely with alendronate and ibandronate than risedronate. There was a greater decrease in bone markers if baseline bone turnover markers were higher and if the patient took more than 80 % of her medication. INTRODUCTION: Biochemical response to bisphosphonate therapy can be assessed using either a decrease in bone turnover marker beyond the least significant change (LSC) or a reduction to within a reference interval (RI). We compared the performance of these target responses and determined whether response was related to the type of bisphosphonate, compliance and baseline bone turnover markers. METHODS: Biochemical responses to three oral bisphosphonates were assessed in an open, controlled trial comprising 172 postmenopausal osteoporotic women (age 53-84 years), randomised to alendronate, ibandronate or risedronate, plus calcium and vitamin D supplementation for 2 years. The LSC for each marker was derived within the study population, whereas RIs were obtained from a control group of healthy premenopausal women (age 35-40 years). RESULTS: Over 70 % of women achieved a target response for serum CTX and PINP, irrespective of the approach used. The percentage decrease at 12 weeks was greater for women with baseline PINP above the RI -63 % (difference 13 %, 95 % CI 0 to 27.1, P = 0.049) and good compliance -67 % (difference 15.9 %, 95 % CI 6.3 to 25.5, P = 0.001). Responders had a greater increase in spine bone density compared to nonresponders; for example 6.2 vs. 2.3 % (difference 3.9 %, 95 % CI 1.6 to 6.3, P = 0.0011) for PINP LSC. The magnitude of change in bone markers was greater with ibandronate and alendronate than risedronate. CONCLUSIONS: Both approaches to response identified similar proportions of women as responders. Nonresponders had smaller increases in BMD, and we suggest that biochemical assessment of response is a useful tool for the management of women with postmenopausal osteoporosis. FAU - Naylor, K E AU - Naylor KE AD - Academic Unit of Bone Metabolism, The Mellanby Centre for Bone Research, University of Sheffield, Herries Road, Sheffield, South Yorkshire, S5 7AU, UK. k.e.naylor@sheffield.ac.uk. FAU - Jacques, R M AU - Jacques RM AD - School of Health and Related Research, University of Sheffield, Sheffield, UK. FAU - Paggiosi, M AU - Paggiosi M AD - Academic Unit of Bone Metabolism, The Mellanby Centre for Bone Research, University of Sheffield, Herries Road, Sheffield, South Yorkshire, S5 7AU, UK. FAU - Gossiel, F AU - Gossiel F AD - Academic Unit of Bone Metabolism, The Mellanby Centre for Bone Research, University of Sheffield, Herries Road, Sheffield, South Yorkshire, S5 7AU, UK. FAU - Peel, N F A AU - Peel NF AD - Metabolic Bone Centre, Sheffield Teaching Hospitals NHS Foundation Trust, Northern General Hospital, Sheffield, UK. FAU - McCloskey, E V AU - McCloskey EV AD - Academic Unit of Bone Metabolism, The Mellanby Centre for Bone Research, University of Sheffield, Herries Road, Sheffield, South Yorkshire, S5 7AU, UK. FAU - Walsh, J S AU - Walsh JS AD - Academic Unit of Bone Metabolism, The Mellanby Centre for Bone Research, University of Sheffield, Herries Road, Sheffield, South Yorkshire, S5 7AU, UK. FAU - Eastell, R AU - Eastell R AD - Academic Unit of Bone Metabolism, The Mellanby Centre for Bone Research, University of Sheffield, Herries Road, Sheffield, South Yorkshire, S5 7AU, UK. LA - eng GR - MR/K006312/1/MRC_/Medical Research Council/United Kingdom PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20150520 PL - England TA - Osteoporos Int JT - Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA JID - 9100105 RN - 0 (Biomarkers) RN - 0 (Bone Density Conservation Agents) RN - 0 (Diphosphonates) RN - KM2Z91756Z (Risedronic Acid) RN - UMD7G2653W (Ibandronic Acid) RN - X1J18R4W8P (Alendronate) SB - IM CIN - Osteoporos Int. 2016 Jan;27(1):33-5. PMID: 26558378 CIN - Osteoporos Int. 2016 Jan;27(1):37. PMID: 26558379 MH - Administration, Oral MH - Adult MH - Aged MH - Aged, 80 and over MH - Alendronate/administration & dosage/pharmacology/therapeutic use MH - Biomarkers/blood MH - Bone Density/drug effects/physiology MH - Bone Density Conservation Agents/administration & dosage/pharmacology/*therapeutic use MH - Bone Remodeling/*drug effects/physiology MH - Diphosphonates/administration & dosage/pharmacology/*therapeutic use MH - Female MH - Humans MH - Ibandronic Acid MH - Lumbar Vertebrae/physiopathology MH - Middle Aged MH - Osteoporosis, Postmenopausal/*drug therapy/physiopathology MH - Premenopause/blood MH - Reference Values MH - Risedronic Acid/administration & dosage/pharmacology/therapeutic use MH - Treatment Outcome OTO - NOTNLM OT - Bisphosphonate OT - Bone turnover markers OT - Postmenopausal osteoporosis OT - Variability EDAT- 2015/05/21 06:00 MHDA- 2016/10/25 06:00 CRDT- 2015/05/21 06:00 PHST- 2015/02/27 00:00 [received] PHST- 2015/04/21 00:00 [accepted] PHST- 2015/05/21 06:00 [entrez] PHST- 2015/05/21 06:00 [pubmed] PHST- 2016/10/25 06:00 [medline] AID - 10.1007/s00198-015-3145-7 [pii] AID - 10.1007/s00198-015-3145-7 [doi] PST - ppublish SO - Osteoporos Int. 2016 Jan;27(1):21-31. doi: 10.1007/s00198-015-3145-7. Epub 2015 May 20.