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Coherence therapy for postmenopausal osteoporosis: A histomorphometric study

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Summary

Patients suffering from osteoporosis were treated with an ADFR (Activation-Depression-Free-Repeat) scheme composed of phosphate as the activator and diphosphonate as the depressor. Trabecular bone remodeling parameters were assayed and compared on undecalcified sections of iliac crest biopsies obtained from patients before and after the therapeutic reginmen. Since some patients received a composite ADFR regimen with estrogen and/or calcium supplementation during the treatment free period, the accumulated data were subdivided into two groups. Statistical analysis was performed on the comparisons of pre- and post-treatment difference in each group and between groups. The mean total trabecular volume increased significantly (p<0.05) in patients treated with pure ADFR, and increased marginally in patients treated with a composite ADFR. Other static and dynamic paramenters were not significantly different before and after the manipulation in each group. Although the comparisons of treatment effects on each parameter between the two groups were not significantly different at p<0.05 level, the mean increments to the original trabecular bone volume, trabecular diameter and thickness of trabecular interstitial lamella were greater in the pure ADFR group (91.6%, 55.12µm, 39.01µm, respectively) than that of the composite ADFR group (24.45%, 0.02µm, 5.05µm, respectively). In addition, the mean wall thickness was increased in the pure ADFR group and decreased in the composite group.

It is important that the timing of the administrations of drugs be in accordance with the phases of normal BMU' s remodeling cycles. The administration of estrogen and/or calcium during the treatment free period seemed to impair osteoblastic function. The insignificant change before and after the manipulation indicated by the static and dymanic parameters might reflect that second biopsy being taken at the similar remodeling phases as that of the first biopsy. The study suggests that the current ADFR scheme not only halts bone less, but also increases trabecular bone volume in postmenopausal osteoporosis. Eight ADFR cycles, approximately two years, were needed to significantly increase trabecular bone volume in iliac crest biopsy.

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Authors and Affiliations

  1. Department of Bone and Mineral Research, Henry Ford Hospital, 48202, Detroit, MI, U.S.A.

    Mei-Shu Shin

  2. Department of Pathology, Health Sciences Centre, University of Western Ontario, N6A 5C1, London, Ontario, Canada

    Colin Anderson

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  1. Mei-Shu Shin
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  2. Colin Anderson
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Shin, MS., Anderson, C. Coherence therapy for postmenopausal osteoporosis: A histomorphometric study. J Bone Miner Metab 8, 26–33 (1990). https://doi.org/10.1007/BF02377310

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