Long-term treatment with raloxifene, but not bisphosphonates, reduces circulating sclerostin levels in postmenopausal women

• Published in: Osteoporosis international 2012-04, Vol.23 (4), p.1235-1243
• Main Authors: Chung, Y. E., Lee, S. H., Lee, S.-Y., Kim, S.-Y., Kim, H.-H., Mirza, F. S., Lee, S.-K., Lorenzo, J. A., Kim, G. S., Koh, J.-M.
• Format: Article
• Language: English
• Subjects: Aged; Alkaline phosphatase; Alkaline Phosphatase - blood; Biomarkers - blood; Bisphosphonates; Bone Density - drug effects; Bone Density Conservation Agents - administration & dosage; Bone Density Conservation Agents - pharmacology; Bone Density Conservation Agents - therapeutic use; Bone Morphogenetic Proteins - blood; Bone Morphogenetic Proteins - drug effects; Bone turnover; Bones; Diphosphonates - administration & dosage; Diphosphonates - pharmacology; Diphosphonates - therapeutic use; Drug Administration Schedule; Drug therapy; Endocrinology; Estrogen receptors; Estrogens; Female; Genetic Markers - drug effects; Humans; Medicine; Medicine & Public Health; Menopause; Metabolism; Middle Aged; Original Article; Orthopedics; Osteocalcin; Osteocalcin - blood; Osteoporosis; Osteoporosis, Postmenopausal - blood; Osteoporosis, Postmenopausal - drug therapy; Osteoporosis, Postmenopausal - physiopathology; Post-menopause; Raloxifene; Raloxifene Hydrochloride - administration & dosage; Raloxifene Hydrochloride - pharmacology; Raloxifene Hydrochloride - therapeutic use; Retrospective Studies; Rheumatology; Selective Estrogen Receptor Modulators - administration & dosage; Selective Estrogen Receptor Modulators - pharmacology; Selective Estrogen Receptor Modulators - therapeutic use; SOST protein
• ISSN: 0937-941X; 1433-2965
• DOI: 10.1007/s00198-011-1675-1

Summary We determined whether suppression of sclerostin levels by estrogen treatment was mediated by anti-resorptive effect. Raloxifene, but not bisphosphonates, suppressed circulating sclerostin concentration, suggesting that sclerostin may mediate the action of estrogen on bone metabolism, independently of their anti-resorptive effects. Introduction Circulating sclerostin concentrations are higher in postmenopausal than in premenopausal women, and estrogen treatment suppresses sclerostin levels in both men and women. We determined whether anti-resorptives may suppress the circulating sclerostin levels. Methods We conducted a retrospective observational study. Eighty postmenopausal women were treated with raloxifene for 19.4 ± 7.7 months ( n  = 16), bisphosphonates for 19.2 ± 6.7 months ( n  = 32), or were untreated ( n  = 32) for 17.1 ± 4.6 months. Plasma sclerostin concentrations were measured before and after treatment. Results Plasma sclerostin levels after treatment were significantly lower in the raloxifene than in the control group (55.8 ± 23.4 pmol/l vs. 92.1 ± 50.4 pmol/l, p  = 0.046), but were similar between the bisphosphonate and control groups. Relative to baseline, raloxifene treatment markedly reduced plasma sclerostin concentration (−40.7 ± 22.8%, p