Session Title: Osteoarthritis - Clinical Aspects
Session Type: Abstract Submissions (ACR)
Knee osteoarthritis is a chronic disease affecting the global joint and characterized by cartilage degradation as well as subchondral bone remodelling. Effects of strontium ranelate (SrRan) on urinary CTX-II, an osteoarthritis-related biomarker, and on serum CTX-I and b-ALP, two markers of bone metabolism, were investigated.
The urinary level of collagen type II C-telopeptide fragments (uCTX-II), the serum levels of collagen type I C-telopeptide fragments (sCTX-I) and bone phosphatase alkaline (sb-ALP) were assessed in all patients included in the SEKOIA study at baseline and after 3, 6, 12, 24 and 36 months of treatment. 1683 patients have been included in this double-blind, placebo-controlled, randomized, international 3-year phase III study aiming to demonstrate the effects of SrRan on the radiographic progression of knee osteoarthritis and have been allocated to SrRan 1g or 2g per day or placebo. Analyses were performed by SUPREME (Liège) using ELISA (uCTX-II and sCTX-I) or a chemiluminescent immunoenzymatic assay (sb-ALP). CTX-II was corrected for urinary creatinine level. Group comparisons were assessed in the ITT (1371 patients) using a Mann-Whitney-Wilcoxon test for uCTX-II or a general linear model with sex, baseline and centre as covariates for sb-ALP and sCTX-I.
At baseline, no significant difference was observed between the groups on uCTX-II, sCTX-I and sb-ALP levels. At the last visit, uCTX-II was significantly lower in the SrRan 1g and 2g groups than in the placebo group with an estimated mean difference of -0.04 and -0.03 µg/mmol respectively (p=0.003 for SrRan 1g group and p=0.021 for SrRan 2g group).Early differences between the treatment groups were demonstrated at 3 months, uCTX-II was significantly lower in the SrRan 1g and 2g groups than in the placebo group with an estimated mean difference of -0.04 and -0.07 µg/mmol creatinine (p<0.0001) respectively.
The results on bone markers sb-ALP and sCTX-I are those expected with SrRan, the level of sb-ALP was higher in SrRan 2g group compared to placebo and the level of sCTX I was lower in both SrRan groups compared to placebo at all visits from 3 months.
Treatment with strontium ranelate significantly decreases the level of urinary CTX-II compared to placebo in patients suffering from knee osteoarthritis, suggesting that strontium ranelate slows the evolution of knee osteoarthritis.
IBSA, Merck Sharp & Dohme, Nutraveris, Novartis, Pfizer, Rottapharm, Servier, Theramex,
J. Y. Reginster,
Servier, Novartis, Negma, Lilly, Wyeth, Amgen, GlaxoSmithKline, Roche, Merckle, Nycomed, NPS, Theramex, UCB,
Merck Sharp and Dohme, Lilly, Rottapharm, IBSA, Genevrier, Novartis, Servier, Roche, GlaxoSmithKline, Teijin, Teva, Ebewee Pharma, Zodiac, Analis, Theramex, Nycomed, Novo-Nordisk,
Bristol Myers Squibb, Merck Sharp and Dohme, Rottapharm, Teva, Lilly, Novartis, Roche, GlaxoSmithKline, Amgen, Servier,
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/strontium-ranelate-decreases-the-level-of-urinary-ctx-ii-in-patients-with-knee-osteoarthritis/