Antiosteoarthritic effect of estrogen β-receptor modulator in postmenopausal women with knee osteoarthritis and osteopenia. A pilot study
Journal Title: Postępy Nauk Medycznych - Year 2012, Vol 25, Issue 3
Abstract
<b>Aim.</b> The aim of the study was to evaluate the influence of Raloxifene (RLX), a selective estrogen receptor modulator, on the rates of the articular cartilage degradation and bone turnover markers as well as on the modification of clinical symptoms of knee osteoarthritis (KOA) in post-menopausal women with osteopenia.<br><b>Material and methods.</b> The study was conducted among 65 women aged 52-79, the average age of 65.4, with knee osteoarthritis graded 1-3 in Kellgren-Lawrence grading scale, with bone density between T-score –1.0 and –2.0 (in L1-L4 vertebrae and/or femoral neck), with normal ESR and who did not take any osteotrophic medication. Two demographically identical groups were created: a control group (C) and a treatment group (E). In both groups calcium supply was supplemented up to 1200 mg/d and vitamine D<sub>3</sub> supply up to 800 IU/d, however, only group E were given 60 mg/d of raloxifene for 12 months. Markers for type II collagen breakdown (CTX-II) and cartilage oligomeric matrix protein in serum were used to evaluate the influence of raloxifene. Bone tissue metabolism was monitored by the activity of bone alkaline phosphatase (kFOS), osteoprotegerin (OPG), dissoluble receptor activator NF-kappa B (sRANKL) and degradation products from type I collagen t I (CTX-I) in urine on creatinine basis (/Kr). Clinical assessment of the knee was based on the WOMAC and Lequesne indexes.<br><b>Results. </b>No change was observed in group C. In group E there was a statistical decrease in CTX-II, CTX-II/Kr, (OPG) and the WOMAC and Lequesne clinical indices; the decrease in CTX-II i CTX-II/Kr excretion was between 30-40% and the WOMAC and Lequesne indices between 15-20%. A significant correlation between the decrease in CTX-II excretion and the improvement of the WOMAC index was identified, which indicates a parallel anticatabolic process in joints and improvement of the clinical condition of KOA in women treated with RLX.<br><b>Conclusions. </b>Raloxifene administered to women with knee osteoarthritis of average age of 65 in a dose of 60 mg a day for 12 months proves to inhibit the markers of articular cartilage degradation, reduce discomfort and significantly improve the function of the knee measured by WOMAC index.
Authors and Affiliations
Stefan Daniluk
Keywords
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