The potential value of monitoring bone turnover markers among women on alendronate

Bell, KJL; Hayen, A; Irwig, L; Hochberg, MC; Ensrud, KE; Cummings, SR; Bauer, DC

The potential value of monitoring bone turnover markers among women on alendronate

Bell, KJL Hayen, A

Irwig, L Hochberg, MC Ensrud, KE Cummings, SR Bauer, DC

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Publication Type:: Journal Article
Citation:: Journal of Bone and Mineral Research, 2012, 27 (1), pp. 195 - 201
Issue Date:: 2012-01-01

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Field	Value	Language
dc.contributor.author	Bell, KJL	en_US
dc.contributor.author	Hayen, A https://orcid.org/0000-0003-4046-8030	en_US
dc.contributor.author	Irwig, L	en_US
dc.contributor.author	Hochberg, MC	en_US
dc.contributor.author	Ensrud, KE	en_US
dc.contributor.author	Cummings, SR	en_US
dc.contributor.author	Bauer, DC	en_US
dc.date.available	2011-09-22	en_US
dc.date.issued	2012-01-01	en_US
dc.identifier.citation	Journal of Bone and Mineral Research, 2012, 27 (1), pp. 195 - 201	en_US
dc.identifier.issn	0884-0431	en_US
dc.identifier.uri	http://hdl.handle.net/10453/115128
dc.description.abstract	Biochemical markers of bone turnover have been proposed to monitor the response to bisphosphonate therapy for osteoporosis, but this requires true between-person differences in the response to therapy. Using mixed models we analyzed three annual measurements of two markers (bone alkaline phosphatase [BAP] and cross-linked N-telopeptide of type I collagen [NTX]) from the Fracture Intervention Trial. We compared marker variation among women allocated to alendronate with that among women allocated to placebo to estimate how much variation was due to true between-person differences in response to treatment, and how much was due to random within-person fluctuations unrelated to treatment. For both markers we found that the mean effect of treatment differed by the baseline level of the marker. After allowing for this and other effects, we found large true between-person differences in response to treatment for both markers, with a coefficient of variation (CV) for NTX of 25.1% and for BAP of 21.2%. However, random within-person fluctuation was even larger, with a CV for change in NTX of 42.5% and for change in BAP of 25.8%. Although repeated measurements have the potential to reduce within person variability, even triplicate baseline marker measurements resulted in an averaged value that was only within 31% of the true value with 95% certainty. In summary, although bone turnover markers appear promising for monitoring between-person differences in response to treatment, their use in clinical practice is currently limited by large random within-person variation. Copyright © 2012 American Society for Bone and Mineral Research.	en_US
dc.relation.ispartof	Journal of Bone and Mineral Research	en_US
dc.relation.isbasedon	10.1002/jbmr.525	en_US
dc.subject.classification	Anatomy & Morphology	en_US
dc.subject.mesh	Bone and Bones	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Alendronate	en_US
dc.subject.mesh	Collagen Type I	en_US
dc.subject.mesh	Alkaline Phosphatase	en_US
dc.subject.mesh	Peptides	en_US
dc.subject.mesh	Biomarkers	en_US
dc.subject.mesh	Bone Remodeling	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Middle Aged	en_US
dc.subject.mesh	Models, Biological	en_US
dc.subject.mesh	Placebos	en_US
dc.subject.mesh	Reproducibility of Results	en_US
dc.title	The potential value of monitoring bone turnover markers among women on alendronate	en_US
dc.type	Journal Article
utslib.citation.volume	1	en_US
utslib.citation.volume	27	en_US
utslib.for	111702 Aged Health Care	en_US
utslib.for	06 Biological Sciences	en_US
utslib.for	09 Engineering	en_US
utslib.for	11 Medical and Health Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Public Health
utslib.copyright.status	closed_access
pubs.issue	1	en_US
pubs.publication-status	Published	en_US
pubs.volume	27	en_US

Abstract:

Biochemical markers of bone turnover have been proposed to monitor the response to bisphosphonate therapy for osteoporosis, but this requires true between-person differences in the response to therapy. Using mixed models we analyzed three annual measurements of two markers (bone alkaline phosphatase [BAP] and cross-linked N-telopeptide of type I collagen [NTX]) from the Fracture Intervention Trial. We compared marker variation among women allocated to alendronate with that among women allocated to placebo to estimate how much variation was due to true between-person differences in response to treatment, and how much was due to random within-person fluctuations unrelated to treatment. For both markers we found that the mean effect of treatment differed by the baseline level of the marker. After allowing for this and other effects, we found large true between-person differences in response to treatment for both markers, with a coefficient of variation (CV) for NTX of 25.1% and for BAP of 21.2%. However, random within-person fluctuation was even larger, with a CV for change in NTX of 42.5% and for change in BAP of 25.8%. Although repeated measurements have the potential to reduce within person variability, even triplicate baseline marker measurements resulted in an averaged value that was only within 31% of the true value with 95% certainty. In summary, although bone turnover markers appear promising for monitoring between-person differences in response to treatment, their use in clinical practice is currently limited by large random within-person variation. Copyright © 2012 American Society for Bone and Mineral Research.

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http://hdl.handle.net/10453/115128